MEDICARE: MR. CHRISTOPHER SCOTT TAYLOR MA, LPC

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	68096	TX

General Provider Information

NPI Number	:	1588099576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER SCOTT TAYLOR MA, LPC

Provider Business Mailing Address
First Line	:	2201 WOLF ST APT 5205
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-1131
Country	:	US
Telephone Number	:	979-574-3717
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 WOLF ST SUITE 5205
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201
Country	:	US
Telephone Number	:	979-574-3717
Fax Number	:

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

Provider Enumeration Date	:	09/09/2013
Last Update Date	:	09/09/2013

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