Provider Demographics
NPI:1013907658
Name:TAYLOR, CAROL G (EDD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:G
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE SALEM GREEN
Mailing Address - Street 2:SUITE 555
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970
Mailing Address - Country:US
Mailing Address - Phone:978-744-8442
Mailing Address - Fax:978-887-7383
Practice Address - Street 1:ONE SALEM GREEN
Practice Address - Street 2:SUITE 555
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970
Practice Address - Country:US
Practice Address - Phone:978-744-8442
Practice Address - Fax:978-887-7383
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4017103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist