Individual
GARY T TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
17148 LIBRARY BLVD, RUTHER GLEN, VA 22546-5809
(804) 994-4785
Mailing address
PO BOX 8535, FREDERICKSBURG, VA 22404-8535
(804) 994-4785
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904012292
VA
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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