Provider Demographics
NPI:1134158504
Name:TAYLOR, NANCY P (PHD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:P
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 1:20301 SHELBURNE RD
Mailing Address - Street 2:APT # 3
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-5012
Mailing Address - Country:US
Mailing Address - Phone:216-932-0615
Mailing Address - Fax:
Practice Address - Street 1:3591 RESERVE COMMONS DR
Practice Address - Street 2:SUITE 301
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5334
Practice Address - Country:US
Practice Address - Phone:330-764-7916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4714103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical