Provider Demographics
NPI:1538817283
Name:TAYLOR, YVETTE
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 HENRY AVE APT E310
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-6080
Mailing Address - Country:US
Mailing Address - Phone:267-541-0713
Mailing Address - Fax:
Practice Address - Street 1:7901 HENRY AVE APT E310
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-6080
Practice Address - Country:US
Practice Address - Phone:267-541-0713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABE82AFCCE39843E59D7DOtherADULT RESIDENTIAL LICENSING