Individual
AMIA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, LISW
Contact information
Practice address
520 DOUGLAS BLVD, TYLER, TX 75702-8307
(903) 606-1721
Mailing address
2601 BILL OWENS PKWY APT 2018, LONGVIEW, TX 75604-3020
(740) 534-3553
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S 1303508
OH
1041C0700X
Clinical Social Worker
Primary
66877
TX
1041C0700X
Clinical Social Worker
I.1801138
OH
Other
Enumeration date
03/17/2014
Last updated
10/15/2019
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