Provider Demographics
NPI:1396502308
Name:TAYLOR, JENNIFER L (MS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:PERINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:243 PLEASANT POINT DR
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-1116
Mailing Address - Country:US
Mailing Address - Phone:818-402-9672
Mailing Address - Fax:
Practice Address - Street 1:243 PLEASANT POINT DR
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-1116
Practice Address - Country:US
Practice Address - Phone:818-402-9672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist