Individual
ETHAN GRAY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC-A
Contact information
Practice address
426 S LAKE DR, LEXINGTON, SC 29072-3414
(803) 814-5559
Mailing address
426 S LAKE DR, LEXINGTON, SC 29072-3414
(803) 814-5559
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8213
SC
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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