Provider Demographics
NPI:1568678415
Name:TAYLOR, KRISTY ANNETTE (BSW, MED)
Entity Type:Individual
Prefix:MS
First Name:KRISTY
Middle Name:ANNETTE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:BSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3386 MOUNT ZION RD
Mailing Address - Street 2:#924
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6874
Mailing Address - Country:US
Mailing Address - Phone:678-663-4558
Mailing Address - Fax:
Practice Address - Street 1:3386 MOUNT ZION RD
Practice Address - Street 2:#924
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6874
Practice Address - Country:US
Practice Address - Phone:678-663-4558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator