Provider Demographics
NPI:1508542002
Name:TAYLOR, KALAYAH MADISON
Entity Type:Individual
Prefix:
First Name:KALAYAH
Middle Name:MADISON
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 LEGION WAY SE UNIT 306
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6912
Mailing Address - Country:US
Mailing Address - Phone:360-580-9818
Mailing Address - Fax:
Practice Address - Street 1:406 LEGION WAY SE UNIT 306
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-6912
Practice Address - Country:US
Practice Address - Phone:360-580-9818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst