Individual
DANA SHANTEL TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
303 NW 11TH ST, FAIRFIELD, IL 62837-1206
(618) 847-8362
Mailing address
303 NW 11TH ST, FAIRFIELD, IL 62837-1206
(618) 847-8362
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-012230
IL
Other
Enumeration date
01/17/2020
Last updated
01/17/2020
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