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Organization
UPHOLD 3:18
Active
Organization
UPHOLD 3:18
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY T TAYLOR LCSW (LEAD CLINICIAN)
(540) 645-7083
Entity
Organization
Contact information
Practice address
1320 CENTRAL PARK BLVD STE 200, FREDERICKSBURG, VA 22401-4953
(540) 645-7083
Mailing address
1320 CENTRAL PARK BLVD STE 200, FREDERICKSBURG, VA 22401-4953
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/21/2022
Last updated
08/09/2022
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