Provider Demographics
NPI:1457781668
Name:BURCH, TAYLOR ANNAMARIE (LMFT-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANNAMARIE
Last Name:BURCH
Suffix:
Gender:F
Credentials:LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MCGREGOR
Mailing Address - State:TX
Mailing Address - Zip Code:76657-2063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 GHOLSON RD
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76704-1106
Practice Address - Country:US
Practice Address - Phone:209-918-7882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
TX205477106H00000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional