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NPI Code Detail

MEDICARE: LESLIE TAYLOR

MEDICARE: LESLIE 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
11041C0700XClinical Social WorkerP006426NC

General Provider Information

NPI Number : 1710308648
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE TAYLOR
Provider Business Mailing Address
First Line : 8916 WOODHALL LAKE DR
Second Line :
City : WAXHAW
State : NC
Zip : 28173-6800
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8916 WOODHALL LAKE DR
Second Line :
City : WAXHAW
State : NC
Zip : 28173-6800
Country : US
Telephone Number : 704-968-0345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2013
Last Update Date : 12/19/2013

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Directions to “ LESLIE TAYLOR ” Practice Location

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