Provider Demographics
NPI:1689077844
Name:TAYLOR, BEVERLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLEY
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 1:4581 CHARING CROSS ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-2009
Mailing Address - Country:US
Mailing Address - Phone:901-652-1333
Mailing Address - Fax:901-457-7882
Practice Address - Street 1:4046 S PLAZA DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-6335
Practice Address - Country:US
Practice Address - Phone:901-332-6257
Practice Address - Fax:901-457-7882
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000003184101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional