Provider Demographics
NPI:1821808817
Name:TAYLOR, VONITRA (MENTAL HEALTH)
Entity type:Individual
Prefix:
First Name:VONITRA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MENTAL HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5671 SW 35TH LN
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-9444
Mailing Address - Country:US
Mailing Address - Phone:352-234-8358
Mailing Address - Fax:
Practice Address - Street 1:5671 SW 35TH LN
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-9444
Practice Address - Country:US
Practice Address - Phone:352-234-8358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH24622101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health