Individual
SHASTA DENNINE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LCADC, NCC
Contact information
Practice address
13653 CROWS FOOT LN, PRINCESS ANNE, MD 21853-3211
(140) 845-1796
Mailing address
13653 CROWS FOOT LN, PRINCESS ANNE, MD 21853-3211
(140) 845-1796
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA2707
MD
101YP2500X
Professional Counselor
Primary
LC8064
MD
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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