Provider Demographics
NPI:1508161258
Name:TAYLOR, BRIENNE
Entity type:Individual
Prefix:
First Name:BRIENNE
Middle Name:
Last Name:TAYLOR
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 1:40 ORRS LN
Mailing Address - Street 2:
Mailing Address - City:TRIADELPHIA
Mailing Address - State:WV
Mailing Address - Zip Code:26059-1455
Mailing Address - Country:US
Mailing Address - Phone:304-238-3594
Mailing Address - Fax:304-547-9198
Practice Address - Street 1:1243 SHED RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-8584
Practice Address - Country:US
Practice Address - Phone:814-623-5166
Practice Address - Fax:814-623-3460
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health