Provider Demographics
NPI:1467768473
Name:TAYLOR, ADAM JOHN (BSW)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:JOHN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1436
Mailing Address - Country:US
Mailing Address - Phone:617-913-7353
Mailing Address - Fax:
Practice Address - Street 1:24 PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1436
Practice Address - Country:US
Practice Address - Phone:617-913-7353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker