Provider Demographics
NPI:1689457731
Name:TAYLOR, KILEY JEAN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KILEY
Middle Name:JEAN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:KILEY
Other - Middle Name:JEAN
Other - Last Name:STUDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1815 PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72405-7870
Mailing Address - Country:US
Mailing Address - Phone:870-933-6886
Mailing Address - Fax:870-336-1339
Practice Address - Street 1:400 S COLLEGE
Practice Address - Street 2:STE 2
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3142
Practice Address - Country:US
Practice Address - Phone:870-425-1041
Practice Address - Fax:870-425-1049
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker