Provider Demographics
NPI:1508113283
Name:TAYLOR, JENNIFER JONES (MS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JONES
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-8293
Mailing Address - Country:US
Mailing Address - Phone:850-718-2755
Mailing Address - Fax:
Practice Address - Street 1:3416 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-8293
Practice Address - Country:US
Practice Address - Phone:850-718-2755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health