Provider Demographics
NPI:1659883361
Name:TAYLOR, CAPRA ZELEANOR (BACHELOR OF SCIENCE)
Entity type:Individual
Prefix:
First Name:CAPRA
Middle Name:ZELEANOR
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:BACHELOR OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 DILLON DR
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-1017
Mailing Address - Country:US
Mailing Address - Phone:864-582-7588
Mailing Address - Fax:864-562-4117
Practice Address - Street 1:129 DILLON DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1017
Practice Address - Country:US
Practice Address - Phone:864-582-7588
Practice Address - Fax:864-562-4117
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty