Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 862 | AL |
NPI | 1003175100 |
---|---|
Provider Name | Jennifer Jo Taylor |
First Address | Huntsville, AL 35801-3602 |
Second Address | Huntsville, AL 35801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2012 |
Last Update Date | 30/09/2019 |