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Individual

MARIAH MARIE TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW, MSW

Contact information

Practice address
266 6TH AVE SW, EPHRATA, WA 98823-2053
(509) 906-4333
Mailing address
266 6TH AVE SW, EPHRATA, WA 98823-2053
(509) 906-4333

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW61156635
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LW61156635
LICSW WA DOL LICENSE
WA
Enumeration date
05/19/2022
Last updated
05/19/2022
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