Provider Demographics
NPI:1194531830
Name:ALLEN, TAYLOR GRACE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:GRACE
Last Name:ALLEN
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 1:4801 WOODWAY DR STE 318W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-1642
Mailing Address - Country:US
Mailing Address - Phone:713-364-4155
Mailing Address - Fax:
Practice Address - Street 1:4801 WOODWAY DR STE 318W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-1642
Practice Address - Country:US
Practice Address - Phone:713-364-4155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-07
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114316104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker