Provider Demographics
NPI:1124089628
Name:TAYLOR, TAMARAH LEIGH (LCSW)
Entity type:Individual
Prefix:
First Name:TAMARAH
Middle Name:LEIGH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 W 1290 N
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-1530
Mailing Address - Country:US
Mailing Address - Phone:801-712-3412
Mailing Address - Fax:
Practice Address - Street 1:1640 W 1290 N
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-1530
Practice Address - Country:US
Practice Address - Phone:801-712-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-01
Last Update Date:2025-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5374232-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical