Individual
KERRY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(478) 321-7070
Mailing address
17924 W LAS PALMARITAS DR, WADDELL, AZ 85355-7812
(478) 321-7070
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC16308
AZ
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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