Provider Demographics
NPI:1609442474
Name:TAYLOR, JON MICHAEL (HYPNOTHERAPIST)
Entity type:Individual
Prefix:MR
First Name:JON
Middle Name:MICHAEL
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:HYPNOTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9795
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-0014
Mailing Address - Country:US
Mailing Address - Phone:085-091-1695
Mailing Address - Fax:401-208-0478
Practice Address - Street 1:385 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-1547
Practice Address - Country:US
Practice Address - Phone:508-509-1169
Practice Address - Fax:401-208-0478
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH33097101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH33097OtherNATIONAL GUILD OF HYPNOSIS