Provider Demographics
NPI:1568817047
Name:TAYLOR, NORRESHA S
Entity type:Individual
Prefix:
First Name:NORRESHA
Middle Name:S
Last Name:TAYLOR
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 1:874 CLUBTRAIL DR APT L
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-2398
Mailing Address - Country:US
Mailing Address - Phone:270-485-8573
Mailing Address - Fax:
Practice Address - Street 1:874 CLUBTRAIL DR APT L
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2398
Practice Address - Country:US
Practice Address - Phone:270-485-8573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2551691041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical