Provider Demographics
NPI:1841731833
Name:CAYLOR, MARILYN (MA, LPC)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:CAYLOR
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25679 GREEN RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-6450
Mailing Address - Country:US
Mailing Address - Phone:210-255-2541
Mailing Address - Fax:
Practice Address - Street 1:25679 GREEN RIVER DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-6450
Practice Address - Country:US
Practice Address - Phone:210-255-2541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-10
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75855101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional