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Individual

JENNA K TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1760 MANLEY RD, MAUMEE, OH 43537-9400
(419) 509-7214
Mailing address
1760 MANLEY RD, MAUMEE, OH 43537-9400
(419) 509-7214

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.180915
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1033608195
OH
Enumeration date
06/03/2022
Last updated
06/03/2022
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