Provider Demographics
NPI:1821795808
Name:SMALL, TAYLOR DEVIN (QMHS)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:DEVIN
Last Name:SMALL
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 KESTRAL WAY
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-2876
Mailing Address - Country:US
Mailing Address - Phone:440-654-8271
Mailing Address - Fax:
Practice Address - Street 1:3343 COMMUNITY COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3322
Practice Address - Country:US
Practice Address - Phone:216-443-3139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator