Provider Demographics
NPI:1659423507
Name:TAYLOR, TAMMY LEE
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LEE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:LEE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1008 ORIOLE CIR S
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-8829
Mailing Address - Country:US
Mailing Address - Phone:570-428-5373
Mailing Address - Fax:
Practice Address - Street 1:1008 ORIOLE CIR S
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-8829
Practice Address - Country:US
Practice Address - Phone:570-428-5373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional