Provider Demographics
NPI:1730157108
Name:TAYLOR, DONNA (LSW)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 N MARR RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-6660
Mailing Address - Country:US
Mailing Address - Phone:812-314-3400
Mailing Address - Fax:812-378-8367
Practice Address - Street 1:1530 COMMERCE PARK WEST DRIVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240
Practice Address - Country:US
Practice Address - Phone:812-663-7057
Practice Address - Fax:812-663-6735
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33000385A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker