Provider Demographics
NPI:1700162286
Name:TAYLOR, CAPRI ANGELIC (MA, PLPC, CRAADC,SQP)
Entity type:Individual
Prefix:
First Name:CAPRI
Middle Name:ANGELIC
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA, PLPC, CRAADC,SQP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 S INGRAM AVE
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-7535
Mailing Address - Country:US
Mailing Address - Phone:660-827-9875
Mailing Address - Fax:
Practice Address - Street 1:1721 S INGRAM AVE
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-7535
Practice Address - Country:US
Practice Address - Phone:660-827-9875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011035690101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional