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Individual

ROBERT TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, LADC, CCS

Contact information

Practice address
1250 FOREST AVE STE 201, PORTLAND, ME 04103-6403
(207) 370-5458
Mailing address
145 SETTLER RD, SOUTH PORTLAND, ME 04106-4046
(978) 398-1728

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC8168
ME
1041C0700X
Clinical Social Worker
Primary
LC23784
ME

Other

Enumeration date
08/14/2022
Last updated
07/28/2024
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