Provider Demographics
NPI:1154069870
Name:WEST, TAYLOR M
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:M
Last Name:WEST
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 1:128 WINDY RIDGE RD APT 2
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12122-7013
Mailing Address - Country:US
Mailing Address - Phone:518-764-1667
Mailing Address - Fax:
Practice Address - Street 1:128 WINDY RIDGE RD APT 2
Practice Address - Street 2:
Practice Address - City:MIDDLEBURGH
Practice Address - State:NY
Practice Address - Zip Code:12122-7013
Practice Address - Country:US
Practice Address - Phone:518-764-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker