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Individual

CHEYENNE TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
911-913 STATE ST, SSCS, NEW HAVEN, CT 06511-3926
(203) 503-3530
(203) 503-6243
Mailing address
26 VALLEY RD, CLINTON, CT 06413-1234
(203) 804-6187

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11028
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004235918
CT
Enumeration date
03/03/2020
Last updated
06/26/2020
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