Provider Demographics
NPI:1891567558
Name:WARREN, TAUNDRA UYVETTE
Entity Type:Individual
Prefix:MRS
First Name:TAUNDRA
Middle Name:UYVETTE
Last Name:WARREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 OWENS ST
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-5041
Mailing Address - Country:US
Mailing Address - Phone:334-379-2787
Mailing Address - Fax:
Practice Address - Street 1:930 PRIVATE ROAD 1601
Practice Address - Street 2:
Practice Address - City:CHANCELLOR
Practice Address - State:AL
Practice Address - Zip Code:36316-7268
Practice Address - Country:US
Practice Address - Phone:334-379-2787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health