Individual
JEREMIAH TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0261L
AR
101YP2500X
Professional Counselor
Primary
P1810139
AR
106H00000X
Marriage & Family Therapist
M0708004
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0261L
LICENSED ALCOHOLISM AND DRUG ABUSE COUNSELOR
AR
01
—
M0708004
LMFT
AR
Enumeration date
04/18/2012
Last updated
12/27/2018
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