Provider Demographics
NPI:1902551575
Name:TAYLOR, LISA STERN (MFT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:STERN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 HILLSIDE LN
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1076
Mailing Address - Country:US
Mailing Address - Phone:484-639-9476
Mailing Address - Fax:
Practice Address - Street 1:406 HILLSIDE LN
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1076
Practice Address - Country:US
Practice Address - Phone:484-639-9476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-13
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist