Provider Demographics
NPI:1275161507
Name:TAYLOR, LEAH MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:MARIE
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 1:615 STONE MILL CT
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-3217
Mailing Address - Country:US
Mailing Address - Phone:954-214-9620
Mailing Address - Fax:
Practice Address - Street 1:10440 SHAKER DR STE 203
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2346
Practice Address - Country:US
Practice Address - Phone:410-740-2468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06320103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty