Provider Demographics
NPI:1558744136
Name:TAYLOR, PATRICIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
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 1:322 WEST RD
Mailing Address - Street 2:C/O MAINE CHILD PSYCHOLOGY
Mailing Address - City:BELGRADE
Mailing Address - State:ME
Mailing Address - Zip Code:04917-4111
Mailing Address - Country:US
Mailing Address - Phone:207-221-2631
Mailing Address - Fax:
Practice Address - Street 1:322 WEST RD
Practice Address - Street 2:C/O MAINE CHILD PSYCHOLOGY
Practice Address - City:BELGRADE
Practice Address - State:ME
Practice Address - Zip Code:04917-4111
Practice Address - Country:US
Practice Address - Phone:207-221-2631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPE1491103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool