Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 1584 | TN |
NPI | 1003070277 |
---|---|
Provider Name | Bonnye Griffin-Taylor |
First Address | Memphis, TN 38103-2807 |
Second Address | Memphis, TN 38107-2805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2008 |
Last Update Date | 16/07/2008 |