Provider Demographics
NPI:1295436632
Name:TAGLIOLA, LAUREN REBECCA (MS, RMHCI)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:REBECCA
Last Name:TAGLIOLA
Suffix:
Gender:F
Credentials:MS, RMHCI
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:REBECCA
Other - Last Name:TAGLIOLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAUREN DENAHAN, MS
Mailing Address - Street 1:5555 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6476
Mailing Address - Country:US
Mailing Address - Phone:954-693-6406
Mailing Address - Fax:
Practice Address - Street 1:5555 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6476
Practice Address - Country:US
Practice Address - Phone:954-693-6406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20931101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty