Provider Demographics
NPI:1962783407
Name:TAYLOR, DONNA G (MSA, LAC)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:G
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSA, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 E UNION HILLS DR
Mailing Address - Street 2:#10-C
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-8400
Mailing Address - Country:US
Mailing Address - Phone:623-581-3300
Mailing Address - Fax:
Practice Address - Street 1:814 E UNION HILLS DR
Practice Address - Street 2:#10-C
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-8400
Practice Address - Country:US
Practice Address - Phone:623-581-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0702171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist