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NPI Code Detail

MEDICARE: KRISTIN MARIE TAYLOR

MEDICARE: KRISTIN MARIE 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
1222Q00000XDevelopmental Therapist
21041C0700XClinical Social WorkerLCSW-5190HI

General Provider Information

NPI Number : 1306248968
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN MARIE TAYLOR
Provider Business Mailing Address
First Line : 7000 HAWAII KAI DR APT 2514
Second Line :
City : HONOLULU
State : HI
Zip : 96825-4184
Country : US
Telephone Number : 808-295-0616
Fax Number :
Provider Business Practice Location Address
First Line : 860 IWILEI RD
Second Line :
City : HONOLULU
State : HI
Zip : 96817-5018
Country : US
Telephone Number : 808-295-0616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2014
Last Update Date : 06/16/2025

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Directions to “ KRISTIN MARIE TAYLOR ” Practice Location

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