Individual
MS. TAYLOR RAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P-LCSW
Contact information
Practice address
PO BOX 1192, DONNELLY, ID 83615-1100
(253) 968-2303
(253) 968-1151
Mailing address
9040 FITZSIMMONS DR, JOINT BASE LEWIS MCCHORD, WA 98431-1100
(253) 968-2303
(253) 968-1151
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW36537
ID
390200000X
Student in an Organized Health Care Education/Training Program
P-006670
NC
Other
Enumeration date
07/26/2011
Last updated
02/04/2025
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