Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | AC2264 | MD |
NPI | 1003085382 |
---|---|
Provider Name | Mrs. Patricia Lynn Taylor |
First Address | Prince Frederick, MD 20678-0980 |
Second Address | Prince Frederick, MD 20678-3582 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2008 |
Last Update Date | 25/08/2016 |