Provider Demographics
NPI:1528205010
Name:TAYLOR, APRIL GAETANA
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:GAETANA
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:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28053-0215
Mailing Address - Country:US
Mailing Address - Phone:704-853-8227
Mailing Address - Fax:704-853-8272
Practice Address - Street 1:436 E LONG AVE
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2516
Practice Address - Country:US
Practice Address - Phone:704-853-8227
Practice Address - Fax:704-853-8272
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0500658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health