Individual
CAROL TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
70 SOUTH WILLOW, JACKSON, WY 83001
(208) 787-4170
Mailing address
PO BOX 331, VICTOR, ID 83455-0331
(208) 787-4170
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-809
WY
1041C0700X
Clinical Social Worker
LMSW-791
ID
Other
Enumeration date
02/12/2010
Last updated
01/04/2017
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