Individual
DWAYNE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4328 RUSHMORE PL, FOREST PARK, GA 30297-1024
(404) 666-3268
Mailing address
5414 BIFFLE WAY, STONE MOUNTAIN, GA 30088
(404) 944-2056
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW006933
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609231463
—
GA
Enumeration date
12/22/2015
Last updated
09/24/2018
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