Provider Demographics
NPI:1548689953
Name:TAYLOR-WOOD, AUDREY SHARON (LCSW)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:SHARON
Last Name:TAYLOR-WOOD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8335 E MACKENZIE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-2810
Mailing Address - Country:US
Mailing Address - Phone:602-679-3691
Mailing Address - Fax:
Practice Address - Street 1:11300 N 64TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5007
Practice Address - Country:US
Practice Address - Phone:602-679-3691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 108021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical