Provider Demographics
NPI:1700555380
Name:LOFTUS, TAYLOR RAE (MA)
Entity Type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:RAE
Last Name:LOFTUS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 UNIVERSITY BLVD W APT 1016
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-3321
Mailing Address - Country:US
Mailing Address - Phone:954-330-1673
Mailing Address - Fax:
Practice Address - Street 1:107 CARPENTER DR STE 110
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-4468
Practice Address - Country:US
Practice Address - Phone:703-297-4368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor