Provider Demographics
NPI:1952123424
Name:SOHN, TAYLOR JOY
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JOY
Last Name:SOHN
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 1:117 HAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MOSCOW MILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63362
Mailing Address - Country:US
Mailing Address - Phone:636-459-5596
Mailing Address - Fax:
Practice Address - Street 1:117 HAYFIELD DR
Practice Address - Street 2:
Practice Address - City:MOSCOW MILLS
Practice Address - State:MO
Practice Address - Zip Code:63362
Practice Address - Country:US
Practice Address - Phone:636-459-5596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024043192103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst