Taylor, Mary Lou
Taylor, Mary Lou is an individual health care provider with primary practice located at Froedtert & Med College Clin - East 9200 West Wisconsin Avenue, Milwaukee WI 53226. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Taylor, Mary Lou can be contacted via phone (414) 805-3666.Contact Information
Primary practice address
Froedtert & Med College Clin - East 9200 West Wisconsin Avenue
Milwaukee WI 53226
Phone: (414) 805-3666
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1307 | Wisconsin |
Profile Details
| NPI number | 1235180985 |
|---|---|
| LBN Legal business name | Taylor, Mary Lou |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2006 |
| Last updated | Nov 12th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235180985 | NPPES |
| Wisconsin | MEDICAID | 39074000 |
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