Individual
MS. LINDA RAE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
113 LINCOLN WAY EAST, MISHAWAKA, IN 46544-2016
(574) 255-4976
(574) 255-1882
Mailing address
113 LINCOLN WAY EAST, MISHAWAKA, IN 46544-2016
(574) 255-4976
(574) 255-1882
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
34004651
IN
1041C0700X
Clinical Social Worker
Primary
34004651A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000341224
ANTHEM
IN
01
—
7701931
AETNA
IN
Enumeration date
11/13/2006
Last updated
01/19/2008
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