Provider Demographics
NPI:1770943615
Name:TAYLOR-SMITH, RACHEL (MC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:TAYLOR-SMITH
Suffix:
Gender:F
Credentials:MC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1772 E BOSTON ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-6242
Mailing Address - Country:US
Mailing Address - Phone:480-649-6499
Mailing Address - Fax:480-207-2580
Practice Address - Street 1:1772 E BOSTON ST
Practice Address - Street 2:SUITE 107
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-6242
Practice Address - Country:US
Practice Address - Phone:480-649-6499
Practice Address - Fax:480-207-2580
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-13985101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health