Provider Demographics
NPI:1467731703
Name:TAYLOR, SHEILA ANN
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:ANN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHEILA
Other - Middle Name:ANN
Other - Last Name:OTHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCDC
Mailing Address - Street 1:609 FINLEY ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-4219
Mailing Address - Country:US
Mailing Address - Phone:469-285-0654
Mailing Address - Fax:972-446-4334
Practice Address - Street 1:609 FINLEY ST
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-4219
Practice Address - Country:US
Practice Address - Phone:469-285-0654
Practice Address - Fax:972-446-4334
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10181101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor