Provider Demographics
NPI:1114135878
Name:TAYLOR, KIJANA SAYIDA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KIJANA
Middle Name:SAYIDA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 WOODGROVE PARK DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-1596
Mailing Address - Country:US
Mailing Address - Phone:314-387-0127
Mailing Address - Fax:
Practice Address - Street 1:1568 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-1432
Practice Address - Country:US
Practice Address - Phone:314-387-0127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1223961041C0700X
MO20140132851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical