Provider Demographics
NPI:1891526497
Name:TAYLOR, MARY YOLANDA (MED)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:YOLANDA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13030 BARKLEY BEND LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-6583
Mailing Address - Country:US
Mailing Address - Phone:713-291-2173
Mailing Address - Fax:
Practice Address - Street 1:12337 JONES RD STE 422
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4845
Practice Address - Country:US
Practice Address - Phone:281-826-9777
Practice Address - Fax:281-369-6531
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94910101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health