Provider Demographics
NPI:1407530496
Name:TAYLOR, CHERYL (MBA, CE)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MBA, CE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CENTENNIAL ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-7500
Mailing Address - Country:US
Mailing Address - Phone:301-807-7973
Mailing Address - Fax:240-266-2422
Practice Address - Street 1:975 RYE DR
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-3295
Practice Address - Country:US
Practice Address - Phone:301-807-7973
Practice Address - Fax:240-266-2422
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No251K00000XAgenciesPublic Health or Welfare