Provider Demographics
NPI:1205231255
Name:TAYLOR, AMANDA ASHLEY (MA)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:ASHLEY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:ASHLEY
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:4600 SW 13TH ST
Mailing Address - Street 2:1460
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-3904
Mailing Address - Country:US
Mailing Address - Phone:352-328-8695
Mailing Address - Fax:
Practice Address - Street 1:4300 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-4006
Practice Address - Country:US
Practice Address - Phone:352-328-8695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health