Provider Demographics
NPI:1437349107
Name:TAYLOR, JIL MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:JIL
Middle Name:MARIE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-2010
Mailing Address - Country:US
Mailing Address - Phone:509-758-9698
Mailing Address - Fax:509-758-9664
Practice Address - Street 1:629 6TH ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-2010
Practice Address - Country:US
Practice Address - Phone:509-758-9698
Practice Address - Fax:509-758-9664
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC0005858564101Y00000X
IDLMSW-28303104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor