Provider Demographics
NPI:1073791802
Name:TAYLOR, DONNA B (MA)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:B
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-3111
Mailing Address - Country:US
Mailing Address - Phone:662-843-1699
Mailing Address - Fax:
Practice Address - Street 1:1100 W HIGHWAY 8
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2261
Practice Address - Country:US
Practice Address - Phone:662-402-8317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST0163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health