Provider Demographics
NPI:1659761963
Name:RUNHAAR-TAYLOR, AIMEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:
Last Name:RUNHAAR-TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9070 KIMBERLY BLVD
Mailing Address - Street 2:STE 50
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2861
Mailing Address - Country:US
Mailing Address - Phone:561-852-0910
Mailing Address - Fax:561-852-0960
Practice Address - Street 1:2717 E OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1664
Practice Address - Country:US
Practice Address - Phone:954-288-0131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 64901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical