Provider Demographics
NPI:1013589431
Name:MUIR-TAYLOR, GEORGIA ANN
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:ANN
Last Name:MUIR-TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35206-3454
Mailing Address - Country:US
Mailing Address - Phone:205-907-1488
Mailing Address - Fax:
Practice Address - Street 1:8301 8TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35206-3454
Practice Address - Country:US
Practice Address - Phone:205-907-1488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5503G101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCBZZ103462851OtherBLUE CROSS BLUE SHIELD