Provider Demographics
NPI:1013374412
Name:TAYLOR, WENDY (LMFT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33211 KAYLEE WAY
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-3831
Mailing Address - Country:US
Mailing Address - Phone:352-501-8210
Mailing Address - Fax:407-867-6316
Practice Address - Street 1:4400 N HIGHWAY 19A
Practice Address - Street 2:SUITE 5
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-2032
Practice Address - Country:US
Practice Address - Phone:352-315-7800
Practice Address - Fax:352-315-7587
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 3121106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist