Most Relevant Information
Provider Data
| NPI Number: | 1003479460 |
| Provider Name: | NICOLETTE TAYLOR LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 178014443 |
Most Important Dates
| Enumeration Date: | 04/20/2019 |
| Last Updated: | 04/20/2019 |
Provider Practice Location
935 175TH ST
HOMEWOOD
IL
604302049
Practice Location Phone/Fax
| Phone: | 3123881505 |
| Fax: |
Provider Mailing Location
935 175TH ST
HOMEWOOD
IL
604302049
Provider Mailing Phone/Fax
| Phone: | 3123881505 |
| Fax: |