MEDICARE: ANGELA NICHOLE TAYLOR LPC, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	83016	TX

General Provider Information

NPI Number	:	1194392381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA NICHOLE TAYLOR LPC, MS

Provider Business Mailing Address
First Line	:	1018 MARGATE CT
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-2301
Country	:	US
Telephone Number	:	281-685-2503
Fax Number	:

Provider Business Practice Location Address
First Line	:	1018 MARGATE CT
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-2301
Country	:	US
Telephone Number	:	281-685-2503
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2021
Last Update Date	:	01/10/2022

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