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:
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Health care specialties

SpecialtyCodeLicense #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 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235180985 NPPES
Wisconsin MEDICAID 39074000

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