Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | CG60246007 | WA |
Y | 101YM0800X | Mental Health Counselor | CG60246007 | WA |
NPI | 1003197963 |
---|---|
Provider Name | Janet Matilda Taylor |
First Address | Seattle, WA 98122-2735 |
Second Address | Seattle, WA 98105-5414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2011 |
Last Update Date | 22/05/2013 |