Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 6301016870 | MI |
N | 103TS0200X | School Psychologist | PP0000000891687 | MI |
NPI | 1063954626 |
---|---|
Provider Name | Dr. Taylor Hicks-Hoste |
First Address | Chelsea, MI 48118-1370 |
Second Address | Chelsea, MI 48118-1370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2016 |
Last Update Date | 14/11/2016 |