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Individual

TARAKA TAYLOR-MOULTRIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW-CP

Contact information

Practice address
780 CHARTER DR UNIT B11, LONGS, SC 29568-5833
(478) 361-2126
Mailing address
780 CHARTER DR UNIT B11, LONGS, SC 29568-5833
(478) 361-2126

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14372
SC

Other

Enumeration date
06/11/2021
Last updated
06/11/2021
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