Provider Demographics
NPI:1568221513
Name:TAYLOR, JENNIFER NICOLE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:NICOLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:YINGLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3120 N OAK STREET EXT STE C
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-5910
Mailing Address - Country:US
Mailing Address - Phone:229-671-6170
Mailing Address - Fax:
Practice Address - Street 1:3120 N OAK STREET EXT STE B
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-5910
Practice Address - Country:US
Practice Address - Phone:229-671-6170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist