Provider Demographics
NPI:1972751253
Name:TAYLOR-WYCOFF, DIONNE MARIE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:DIONNE
Middle Name:MARIE
Last Name:TAYLOR-WYCOFF
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 1:448 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-5612
Mailing Address - Country:US
Mailing Address - Phone:917-209-2177
Mailing Address - Fax:718-452-2652
Practice Address - Street 1:448 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-5612
Practice Address - Country:US
Practice Address - Phone:917-209-2177
Practice Address - Fax:718-452-2652
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049862-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker