Provider Demographics
NPI:1700307592
Name:TEMPLIN-VIELE, TAYLOR CHRISTINE (EDS, NCSP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:CHRISTINE
Last Name:TEMPLIN-VIELE
Suffix:
Gender:F
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 GLENPARK LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3068
Mailing Address - Country:US
Mailing Address - Phone:804-517-0766
Mailing Address - Fax:
Practice Address - Street 1:507 GLENPARK LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3068
Practice Address - Country:US
Practice Address - Phone:804-517-0766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool