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General NPI Number Information
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NPI Number | 1871358507
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Entity Type | Organization
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Legal Business Name | TAYLORED LIVING, LLC
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Dates
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Enumeration Date | 02/21/2024
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 6 SPRING STREET
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City | BEL AIR
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State | MD
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Zip | 21014
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Country | US
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Telephone | 703-835-4396
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Fax |
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Provider Business Mailing Address
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Address Line | 6 SPRING ST
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City | BEL AIR
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State | MD
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Zip | 21014-2366
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Country | US
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Telephone | 703-835-4396
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TAYLORE DONNYE MOUNTAIN
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Credential | LMFT
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Telephone | 703-835-4396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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