Provider Demographics
NPI:1073656690
Name:TAYLOR, CECILE M (BS)
Entity Type:Individual
Prefix:MRS
First Name:CECILE
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MS
Other - First Name:CECILE
Other - Middle Name:M
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1266
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:WA
Mailing Address - Zip Code:99166-1266
Mailing Address - Country:US
Mailing Address - Phone:509-775-3341
Mailing Address - Fax:
Practice Address - Street 1:65 NORTH KELLER
Practice Address - Street 2:
Practice Address - City:REPUBLIC
Practice Address - State:WA
Practice Address - Zip Code:99166-9701
Practice Address - Country:US
Practice Address - Phone:509-775-3341
Practice Address - Fax:509-775-8906
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60146060101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACG60146060OtherCOUNSELOR AGENCY AFFILIATED REGISTRATION