Provider Demographics
NPI:1740782648
Name:TUOZZOLO, TAYLOR (LCSW)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:TUOZZOLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5676 ANNIE ST APT A
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-1996
Mailing Address - Country:US
Mailing Address - Phone:803-367-3428
Mailing Address - Fax:
Practice Address - Street 1:4255 KIMBERWICKE ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-5700
Practice Address - Country:US
Practice Address - Phone:406-616-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT727671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical