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General NPI Number Information
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NPI Number | 1952180465
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Entity Type | Individual
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Provider Name | TAYLOR SHILOH KALL
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Gender | Female
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Dates
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Enumeration Date | 09/25/2023
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Last Update Date | 12/01/2024
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Provider Practice Location Address
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Address Line | 805 W 10TH ST STE 400
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City | AUSTIN
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State | TX
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Zip | 78701-2078
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Country | US
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Telephone | 512-850-4508
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Fax |
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Provider Business Mailing Address
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Address Line | 460 BASTROP HWY S APT 632
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City | AUSTIN
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State | TX
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Zip | 78741-4326
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Country | US
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Telephone | 805-453-6254
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 111339
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License Number State | TX
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