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Individual

MRS. TAYLOR MACKENZIE STOUDENMIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LGC

Contact information

Practice address
125 QUEENS RD STE 520, CHARLOTTE, NC 28204-3512
(980) 302-6270
(980) 302-6275
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(980) 302-6270
(980) 302-6275

Taxonomy

Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
20203
NC
170300000X
Genetic Counselor (M.S.)
20203
SC
170300000X
Genetic Counselor (M.S.)
Primary
30
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20
GENETIC COUNSELOR STATE LICENSURE
SC
01
20203
AMERICAN BOARD OF GENETIC COUNSELING CERTIFICATE
01
GC46
GENETIC COUNSELOR STATE LICENSURE
FL
Enumeration date
06/08/2021
Last updated
10/15/2025
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