Provider Demographics
NPI:1578920070
Name:TAYLOR, ALISON C
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:C
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 1:2740 PROSPERITY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4353
Mailing Address - Country:US
Mailing Address - Phone:703-321-2600
Mailing Address - Fax:703-321-2603
Practice Address - Street 1:2740 PROSPERITY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4353
Practice Address - Country:US
Practice Address - Phone:703-321-2600
Practice Address - Fax:703-321-2603
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040091141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical