Provider Demographics
NPI:1164551552
Name:TAYLOR, PAMELA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 COURT ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-2909
Mailing Address - Country:US
Mailing Address - Phone:860-687-1085
Mailing Address - Fax:860-687-1907
Practice Address - Street 1:44 COURT ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-2909
Practice Address - Country:US
Practice Address - Phone:860-687-1085
Practice Address - Fax:860-687-1907
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health