Provider Demographics
NPI:1740597632
Name:TAYLOR, STEPHEN
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6462 AMBERVIEW
Mailing Address - Street 2:
Mailing Address - City:UINCORPORATED
Mailing Address - State:TN
Mailing Address - Zip Code:38141-0000
Mailing Address - Country:US
Mailing Address - Phone:901-870-0882
Mailing Address - Fax:
Practice Address - Street 1:6462 AMBERVIEW COVE
Practice Address - Street 2:
Practice Address - City:UINCORPORATED
Practice Address - State:TN
Practice Address - Zip Code:38141-0000
Practice Address - Country:US
Practice Address - Phone:901-870-0882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst