Provider Demographics
NPI:1801789441
Name:TAYLOR, TAYLA MONIQUE (LMSW)
Entity type:Individual
Prefix:
First Name:TAYLA
Middle Name:MONIQUE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2971 E COPPER POINT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-9276
Mailing Address - Country:US
Mailing Address - Phone:208-376-5683
Mailing Address - Fax:
Practice Address - Street 1:2971 E COPPER POINT DR STE 100
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-9276
Practice Address - Country:US
Practice Address - Phone:208-376-5683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID2271460104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker