Provider Demographics
NPI:1659828317
Name:TAYLOR, ANGELA (CBIS BAA)
Entity Type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CBIS BAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W HIGHLAND RD
Mailing Address - Street 2:SUITE 400-600
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-2168
Mailing Address - Country:US
Mailing Address - Phone:517-376-4831
Mailing Address - Fax:517-376-4833
Practice Address - Street 1:138 W HIGHLAND RD
Practice Address - Street 2:SUITE 400-600
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2168
Practice Address - Country:US
Practice Address - Phone:517-376-4831
Practice Address - Fax:517-376-4833
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other