Provider Demographics
NPI:1982078069
Name:TAYLOR, JULIE (LMFT 3415)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMFT 3415
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 FLORA PASS PL
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-2823
Mailing Address - Country:US
Mailing Address - Phone:407-739-7260
Mailing Address - Fax:
Practice Address - Street 1:1921 FLORA PASS PL
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34747-2823
Practice Address - Country:US
Practice Address - Phone:407-739-7260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-30
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT 2393106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist