Individual
MARIE C. TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMFT
Contact information
Practice address
2200 LAKE AVE, SUITE 130, FORT WAYNE, IN 46805-5397
(260) 403-2181
Mailing address
2200 LAKE AVE, SUITE 130, FORT WAYNE, IN 46805-5397
(260) 403-2181
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35000584A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000379467
ANTHEM
IN
01
—
7036838
AETNA
IN
Enumeration date
10/18/2006
Last updated
07/08/2007
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