MEDICARE: TAYLOR STARKEY

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	91056	TX

General Provider Information

NPI Number	:	1780464123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR STARKEY

Provider Business Mailing Address
First Line	:	2551 W VILLA MARIA RD APT 638
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77807-2506
Country	:	US
Telephone Number	:	321-217-1378
Fax Number	:

Provider Business Practice Location Address
First Line	:	2551 W VILLA MARIA RD APT 638
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77807-2506
Country	:	US
Telephone Number	:	321-217-1378
Fax Number	:

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

Provider Enumeration Date	:	10/03/2023
Last Update Date	:	10/03/2023

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Directions to “ TAYLOR STARKEY ” Practice Location

Language	Start Address	Practice Location

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