Provider Demographics
NPI:1407184534
Name:TAYLOR, VIOLA (LMT,NCTMB)
Entity Type:Individual
Prefix:MS
First Name:VIOLA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMT,NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35729 TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2318
Mailing Address - Country:US
Mailing Address - Phone:248-471-3194
Mailing Address - Fax:248-471-7021
Practice Address - Street 1:33930 W 8 MILE RD
Practice Address - Street 2:SUITE 4B
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-5272
Practice Address - Country:US
Practice Address - Phone:248-919-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI393299-00171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor