Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | ||
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1083088017 |
---|---|
Provider Name | Lateefah Taylor |
First Address | Houston, TX 77018-3040 |
Second Address | Houston, TX 77018-3040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2015 |
Last Update Date | 31/03/2017 |