Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 0096731 | NM |
NPI | 1003011354 |
---|---|
Provider Name | Cynthia Marie Taylor |
First Address | Albuquerque, NM 87120-2051 |
Second Address | Albuquerque, NM 87107-3752 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 08/07/2007 |