Provider Demographics
NPI:1528187499
Name:TAYLOR, ALAN LESLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LESLEY
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7931 PICARDY AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3513
Mailing Address - Country:US
Mailing Address - Phone:225-767-2372
Mailing Address - Fax:225-769-6708
Practice Address - Street 1:7931 PICARDY AVE
Practice Address - Street 2:SUITE C
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3513
Practice Address - Country:US
Practice Address - Phone:225-767-2372
Practice Address - Fax:225-769-6708
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA480103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical