Provider Demographics
NPI:1114784261
Name:TAYLOR, SHIKIVIA
Entity Type:Individual
Prefix:
First Name:SHIKIVIA
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 1:3759 WESTMONT DR APT 14
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45205-1243
Mailing Address - Country:US
Mailing Address - Phone:561-914-9539
Mailing Address - Fax:
Practice Address - Street 1:3759 WESTMONT DR APT 14
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45205-1243
Practice Address - Country:US
Practice Address - Phone:561-914-9539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty