Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LPC 198 | CA |
N | 101YM0800X | Mental Health Counselor | MH 10185 | FL |
NPI | 1003154980 |
---|---|
Provider Name | Mrs. Daisy Bernice Taylor |
First Address | Woodland, CA 95695-5869 |
Second Address | Woodland, CA 95695-3758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2013 |
Last Update Date | 28/01/2013 |