Provider Demographics
NPI:1659821205
Name:TAYLOR, JULIA HALL (ISW, MSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:HALL
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:ISW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 MAR WALT DR
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6738
Mailing Address - Country:US
Mailing Address - Phone:850-863-4160
Mailing Address - Fax:850-863-8576
Practice Address - Street 1:1015 MAR WALT DR
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6738
Practice Address - Country:US
Practice Address - Phone:850-863-4160
Practice Address - Fax:850-863-8576
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW109471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical