Provider Demographics
NPI:1871346171
Name:TAYLOR, PAULA OTERO (MS, LCMHC)
Entity type:Individual
Prefix:MISS
First Name:PAULA
Middle Name:OTERO
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, LCMHC
Other - Prefix:MISS
Other - First Name:PAULA
Other - Middle Name:KAY
Other - Last Name:OTERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:CHICKAMAUGA
Mailing Address - State:GA
Mailing Address - Zip Code:30707-0021
Mailing Address - Country:US
Mailing Address - Phone:423-994-5860
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 21
Practice Address - Street 2:
Practice Address - City:CHICKAMAUGA
Practice Address - State:GA
Practice Address - Zip Code:30707-0021
Practice Address - Country:US
Practice Address - Phone:142-399-4586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9694101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health