| NPI | 1700265188 |
|---|---|
| Former Name | TAYLOR MAIRE PHELPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH S1500912) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2020-01-29 |