Taylor, Constance Eugenia
Taylor, Constance Eugenia is an individual health care provider with primary practice located at 1600 Broad Ave , Gulfport MS 39501-3603. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Taylor, Constance Eugenia can be contacted via phone (228) 863-1132.Contact Information
Primary practice address
1600 Broad Ave
Gulfport MS 39501-3603
Phone: (228) 863-1132
Fax: (228) 865-1700
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1588680748 |
|---|---|
| LBN Legal business name | Taylor, Constance Eugenia |
| Credentials | MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588680748 | NPPES |
| Mississippi | MEDICAID | 00018213 |
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