Provider Demographics
NPI:1386318749
Name:BELLE, TAYLOR DENISE MARIE
Entity type:Individual
Prefix:MISS
First Name:TAYLOR
Middle Name:DENISE MARIE
Last Name:BELLE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TAYLOR
Other - Middle Name:DENISE MARIE
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5420 AUTUMN PL
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-3733
Mailing Address - Country:US
Mailing Address - Phone:937-853-6096
Mailing Address - Fax:
Practice Address - Street 1:7031 CORPORATE WAY STE 103
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4262
Practice Address - Country:US
Practice Address - Phone:937-619-9089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-08
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2410338104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker