Provider Demographics
NPI:1528205713
Name:TAYLOR, DONNA VICTORIA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:VICTORIA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3459 DEPEW AVE
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-7016
Mailing Address - Country:US
Mailing Address - Phone:941-204-7130
Mailing Address - Fax:941-637-8029
Practice Address - Street 1:8330 ALAN BLVD
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33982-2321
Practice Address - Country:US
Practice Address - Phone:941-204-7130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9690101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health