Provider Demographics
NPI:1881366078
Name:HUBER, TAYLOR MICHELLE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MICHELLE
Last Name:HUBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 S SPRIGG ST
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-6212
Mailing Address - Country:US
Mailing Address - Phone:573-651-4177
Mailing Address - Fax:
Practice Address - Street 1:20 S SPRIGG ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-6212
Practice Address - Country:US
Practice Address - Phone:573-651-4177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator