1871346171 NPI number — MISS PAULA OTERO TAYLOR M.S., LCMHC

Table of content: MISS PAULA OTERO TAYLOR M.S., LCMHC (NPI 1871346171)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871346171 NPI number — MISS PAULA OTERO TAYLOR M.S., LCMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAYLOR
Provider First Name:
PAULA
Provider Middle Name:
OTERO
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
M.S., LCMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OTERO
Provider Other First Name:
PAULA
Provider Other Middle Name:
KAY
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1871346171
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 21
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICKAMAUGA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30707-0021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-994-5860
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PO BOX 21
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICKAMAUGA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30707-0021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
142-399-4586
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  9694 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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