Provider Demographics
NPI:1063124030
Name:FICHT, TAYLOR JORDAN (CD)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JORDAN
Last Name:FICHT
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17500 BIRCHCREST DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-2735
Mailing Address - Country:US
Mailing Address - Phone:248-470-1939
Mailing Address - Fax:
Practice Address - Street 1:17500 BIRCHCREST DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-2735
Practice Address - Country:US
Practice Address - Phone:248-470-1939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula