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General NPI Number Information
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NPI Number | 1811485857
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Entity Type | Individual
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Provider Name | TAYLOR HENZEL M.ED.
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Gender | Female
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 900C LAKE ST STE 3
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City | RAMSEY
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State | NJ
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Zip | 07446-1281
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Country | US
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Telephone | 201-388-8843
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Fax |
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Provider Business Mailing Address
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Address Line | 303 BRIARWOOD DR
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City | WYCKOFF
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State | NJ
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Zip | 07481-1601
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Country | US
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Telephone | 201-388-8843
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37AC00412400
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License Number State | NJ
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