Provider Demographics
NPI:1801336755
Name:TAYLOR, JENNIFER (PSYD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 LANCASTER AVE BLDG J
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1858
Mailing Address - Country:US
Mailing Address - Phone:484-947-8820
Mailing Address - Fax:484-568-4688
Practice Address - Street 1:270 LANCASTER AVE BLDG J
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1858
Practice Address - Country:US
Practice Address - Phone:484-947-8820
Practice Address - Fax:484-568-4688
Is Sole Proprietor?:No
Enumeration Date:2017-02-26
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020197103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical