Individual
TAYLOR MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC/MHSP-TEMP
Contact information
Practice address
414 SHADYLAKE DR, LA VERGNE, TN 37086-2656
(708) 704-2886
Mailing address
414 SHADYLAKE DR, LA VERGNE, TN 37086-2656
(708) 704-2886
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6013
TN
Other
Enumeration date
08/20/2025
Last updated
08/20/2025
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