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General NPI Number Information
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NPI Number | 1831571884
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Entity Type | Individual
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Provider Name | MYESSIA EUNISSE SIMONE TAYLOR B.A., M.A., DLLP
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Gender | Female
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Dates
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Enumeration Date | 06/26/2015
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 26300 OUTER DR
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City | LINCOLN PARK
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State | MI
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Zip | 48146-2019
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Country | US
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Telephone | 734-785-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 3030 CINNAMON GLEN DR
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City | HOUSTON
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State | TX
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Zip | 77073-6102
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Country | US
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Telephone | 501-541-3946
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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