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General NPI Number Information
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NPI Number | 1871834689
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Entity Type | Organization
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Legal Business Name | TAGGART MARRIAGE & FAMILY THERAPY INC
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Dates
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Enumeration Date | 03/05/2013
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 451 LYTTON AVE
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City | PALO ALTO
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State | CA
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Zip | 94301-1535
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Country | US
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Telephone | 650-223-3314
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Fax |
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Provider Business Mailing Address
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Address Line | 451 LYTTON AVE
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City | PALO ALTO
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State | CA
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Zip | 94301-1535
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Country | US
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Telephone | 650-223-3314
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY TAGGART
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Credential | MFT
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Telephone | 650-223-3314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MFC48850
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License Number State | CA
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