Provider Demographics
NPI:1881581486
Name:TAYLOR, DEAVEON MARQUITIA
Entity type:Individual
Prefix:
First Name:DEAVEON
Middle Name:MARQUITIA
Last Name:TAYLOR
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 STEVENS ST APT A
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31415-8916
Mailing Address - Country:US
Mailing Address - Phone:706-284-7104
Mailing Address - Fax:706-284-7104
Practice Address - Street 1:2612 STEVENS ST APT A
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31415-8916
Practice Address - Country:US
Practice Address - Phone:706-284-7104
Practice Address - Fax:706-284-7104
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst