Provider Demographics
NPI:1083088017
Name:TAYLOR, LATEEFAH
Entity Type:Individual
Prefix:
First Name:LATEEFAH
Middle Name:
Last Name: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 1:2006 W 43RD ST APT 36
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-3040
Mailing Address - Country:US
Mailing Address - Phone:713-409-3719
Mailing Address - Fax:
Practice Address - Street 1:2006 W 43RD ST APT 36
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-3040
Practice Address - Country:US
Practice Address - Phone:713-409-3719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-13
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst