Provider Demographics
NPI:1548429236
Name:TAYLOR, REBECCA LOUISE
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LOUISE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RESERVOIR ST
Mailing Address - Street 2:
Mailing Address - City:CHERRY VALLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01611-3149
Mailing Address - Country:US
Mailing Address - Phone:508-728-7366
Mailing Address - Fax:
Practice Address - Street 1:38 FRONT ST
Practice Address - Street 2:FLOOR 5
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1732
Practice Address - Country:US
Practice Address - Phone:508-756-5400
Practice Address - Fax:508-756-5433
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor