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Individual

GUY O TAYLOR SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
10343 S WESTERN AVE, CHICAGO, IL 60643-2410
(916) 470-1816
Mailing address
10343 S WESTERN AVE, CHICAGO, IL 60643-2410
(916) 470-1816

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
167G00000X
Licensed Psychiatric Technician
PT30264
CA

Other

Enumeration date
01/23/2019
Last updated
10/14/2021
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