Individual
TAYLOR LEA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBHCMS 100732
Contact information
Practice address
2601 WILLOW CIR, LAKE WALES, FL 33898-7029
(863) 254-8665
Mailing address
2601 WILLOW CIR, LAKE WALES, FL 33898-7029
(863) 254-8665
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/06/2021
Last updated
02/07/2021
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