Provider Demographics
NPI:1093173114
Name:ASH, TAYLOR (LISW, IADC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:ASH
Suffix:
Gender:F
Credentials:LISW, IADC
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:WIELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1533 LINDEN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-3121
Mailing Address - Country:US
Mailing Address - Phone:515-612-8485
Mailing Address - Fax:
Practice Address - Street 1:1533 LINDEN ST STE 201
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-3121
Practice Address - Country:US
Practice Address - Phone:515-612-8485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-03
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0780591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical