Provider Demographics
NPI:1104618925
Name:TAYLOR, RAMIYAH CHANTELL (RT)
Entity type:Individual
Prefix:MS
First Name:RAMIYAH
Middle Name:CHANTELL
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RT
Other - Prefix:MS
Other - First Name:RAMIYAH
Other - Middle Name:CHANTELL
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RAMIYAH
Mailing Address - Street 1:1218 SW SAN ANTONIO AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-4837
Mailing Address - Country:US
Mailing Address - Phone:772-333-8087
Mailing Address - Fax:
Practice Address - Street 1:1218 SW SAN ANTONIO AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-4837
Practice Address - Country:US
Practice Address - Phone:772-333-8087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLT460-723-04-514-0103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst