Provider Demographics
NPI:1073084968
Name:TAYLOR, ABHAY FRANCISCO VINCENT
Entity Type:Individual
Prefix:
First Name:ABHAY
Middle Name:FRANCISCO VINCENT
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7005 GAYMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2612
Mailing Address - Country:US
Mailing Address - Phone:443-768-3696
Mailing Address - Fax:
Practice Address - Street 1:3813 W COLD SPRING LN
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5430
Practice Address - Country:US
Practice Address - Phone:443-768-3696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health