Provider Demographics
NPI:1194414136
Name:HAWLEY, TAYLOR JANE (MS)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JANE
Last Name:HAWLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 GLENRIDGE DR APT 248
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4919
Mailing Address - Country:US
Mailing Address - Phone:229-424-4391
Mailing Address - Fax:
Practice Address - Street 1:1899 POWERS FERRY RD SE STE 250
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-8411
Practice Address - Country:US
Practice Address - Phone:678-831-0608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC010014101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional