Provider Demographics
NPI:1659893816
Name:TAYLOR, DESIRE SHENAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:DESIRE
Middle Name:SHENAY
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 1:5457 RICHARD AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-6713
Mailing Address - Country:US
Mailing Address - Phone:512-963-1325
Mailing Address - Fax:
Practice Address - Street 1:4708 ALLIANCE BLVD STE 700
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5317
Practice Address - Country:US
Practice Address - Phone:469-814-4850
Practice Address - Fax:814-469-5678
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37494103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth