Provider Demographics
NPI:1477676104
Name:TAYLOR, LAUREN M (MA)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BENTHAVEN PL
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6210
Mailing Address - Country:US
Mailing Address - Phone:720-340-8624
Mailing Address - Fax:
Practice Address - Street 1:24 BENTHAVEN PL
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6210
Practice Address - Country:US
Practice Address - Phone:720-340-8624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO03786960000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health