Provider Demographics
NPI:1013693258
Name:TAYLOR-WOOLARD, JANELLE ELIZABETH
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:ELIZABETH
Last Name:TAYLOR-WOOLARD
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 1:415 BEASLEY DR APT N3
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2879
Mailing Address - Country:US
Mailing Address - Phone:646-667-1548
Mailing Address - Fax:
Practice Address - Street 1:913 E ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5864
Practice Address - Country:US
Practice Address - Phone:252-999-8559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician