MEDICARE: TAYLOR S SMITH

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1801371729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR S SMITH

Provider Business Mailing Address
First Line	:	680 AMERICAN AVE
Second Line	:
City	:	KING OF PRUSSIA
State	:	PA
Zip	:	19406-4023
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 OBERLIN RD STE 30312
Second Line	:
City	:	MIDDLETOWN
State	:	PA
Zip	:	17057-2998
Country	:	US
Telephone Number	:	717-831-0070
Fax Number	:

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

Provider Enumeration Date	:	09/26/2018
Last Update Date	:	09/26/2018

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Directions to “ TAYLOR S SMITH ” Practice Location

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