Provider Demographics
NPI:1417620725
Name:ANDRUS, TAYLOR MICHELE
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MICHELE
Last Name:ANDRUS
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 1:10555 TURTLEWOOD CT UNIT 1309
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2725
Mailing Address - Country:US
Mailing Address - Phone:409-338-7712
Mailing Address - Fax:
Practice Address - Street 1:7676 HILLMONT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6400
Practice Address - Country:US
Practice Address - Phone:978-400-3016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-01
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86013101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health