Provider Demographics
NPI:1013102383
Name:MARC TAYLOR PHD, PSYCHOLOGIST, P.C.
Entity Type:Organization
Organization Name:MARC TAYLOR PHD, PSYCHOLOGIST, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:E
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:541-556-1860
Mailing Address - Street 1:1375 NE YAQUINA HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-9567
Mailing Address - Country:US
Mailing Address - Phone:541-556-1860
Mailing Address - Fax:
Practice Address - Street 1:1375 NE YAQUINA HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-9567
Practice Address - Country:US
Practice Address - Phone:541-556-1860
Practice Address - Fax:541-343-2751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty