Provider Demographics
NPI:1205275096
Name:TAYLOR, KAYE REYNOLDS
Entity type:Individual
Prefix:
First Name:KAYE
Middle Name:REYNOLDS
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:KAYE
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1525 SPRING PLACE RD SE
Mailing Address - Street 2:APT 523
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-3299
Mailing Address - Country:US
Mailing Address - Phone:423-718-8309
Mailing Address - Fax:
Practice Address - Street 1:183 1ST ST NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-5003
Practice Address - Country:US
Practice Address - Phone:423-718-8309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional