Provider Demographics
NPI:1235843335
Name:CAYLOR, ROWAN
Entity Type:Individual
Prefix:
First Name:ROWAN
Middle Name:
Last Name:CAYLOR
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 1:1217 CLAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46808-3155
Mailing Address - Country:US
Mailing Address - Phone:574-549-0331
Mailing Address - Fax:
Practice Address - Street 1:1217 CLAYTON AVE
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46808-3155
Practice Address - Country:US
Practice Address - Phone:574-549-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor