Individual
TIMOTHY JOSEPH TAYLOR I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.C.D.P.
Contact information
Practice address
188 ACADEMY AVE, PROVIDENCE, RI 02908-4452
(401) 383-5811
(401) 383-5822
Mailing address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 383-5811
(401) 383-5822
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00570
RI
Other
Enumeration date
02/21/2014
Last updated
02/21/2014
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