Individual
ERICNIESHA TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C, LICSW
Contact information
Practice address
1100 WILFORD HALL LOOP, BLDG. 4554, 59 MDW/GME, JBSA LACKLAND, TX 78236-9908
(210) 292-5972
Mailing address
1100 WILFORD HALL LOOP, BLDG. 4554, 59 MDW/GME, JBSA LACKLAND, TX 78236-9908
(210) 292-5972
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
21703
MD
208D00000X
General Practice Physician
Primary
LW61040860
WA
251S00000X
Community/Behavioral Health Agency
SC60721786
WA
Other
Enumeration date
02/21/2017
Last updated
06/19/2025
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