Provider Demographics
NPI:1275796161
Name:TAYLOR, MORIAH ANN (LPC)
Entity Type:Individual
Prefix:MISS
First Name:MORIAH
Middle Name:ANN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 NORLEDGE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64123-1220
Mailing Address - Country:US
Mailing Address - Phone:816-560-5947
Mailing Address - Fax:
Practice Address - Street 1:1524 NE RUSSELL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-2234
Practice Address - Country:US
Practice Address - Phone:816-560-5947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006012621101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health