MEDICARE: LINDA W TAYLOR

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	101Y00000X	Counselor	PRSS-SUP-5039	NV

General Provider Information

NPI Number	:	1194403014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA W TAYLOR

Provider Business Mailing Address
First Line	:	7324 W CHEYENNE AVE STE 7
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7426
Country	:	US
Telephone Number	:	248-867-7617
Fax Number	:	248-281-0468

Provider Business Practice Location Address
First Line	:	7324 W CHEYENNE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7427
Country	:	US
Telephone Number	:	248-867-7617
Fax Number	:	248-281-0648

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

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	07/10/2023

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Directions to “ LINDA W TAYLOR ” Practice Location

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