Provider Demographics
NPI:1871236646
Name:TAYLOR, ASHLEY EVANS (PHD, MSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:EVANS
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3723 SUSSEX DR NE
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-9349
Mailing Address - Country:US
Mailing Address - Phone:734-972-8788
Mailing Address - Fax:
Practice Address - Street 1:3723 SUSSEX DR NE
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-9349
Practice Address - Country:US
Practice Address - Phone:734-972-8788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical