Provider Demographics
NPI:1073793261
Name:TAYLOR, RAEANN M (PHD)
Entity Type:Individual
Prefix:DR
First Name:RAEANN
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:DUQUESNE
Mailing Address - State:PA
Mailing Address - Zip Code:15110-1690
Mailing Address - Country:US
Mailing Address - Phone:412-953-8532
Mailing Address - Fax:412-896-5229
Practice Address - Street 1:1126 GRANT AVE
Practice Address - Street 2:
Practice Address - City:DUQUESNE
Practice Address - State:PA
Practice Address - Zip Code:15110-1690
Practice Address - Country:US
Practice Address - Phone:412-953-8532
Practice Address - Fax:412-896-5229
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-007471-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist