Provider Demographics
NPI:1467790642
Name:TAYLOR, DAVID STEPHEN III (CFTS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:STEPHEN
Last Name:TAYLOR
Suffix:III
Gender:M
Credentials:CFTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 WESTMINSTER ST
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-4724
Mailing Address - Country:US
Mailing Address - Phone:978-577-9984
Mailing Address - Fax:
Practice Address - Street 1:426 WESTMINSTER ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-4724
Practice Address - Country:US
Practice Address - Phone:978-577-9984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACFTS1134171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator