Provider Demographics
NPI:1487784823
Name:TAYLOR, KATHRYN HALL (LPE)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:HALL
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 CHESAPEAKE CIR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-6683
Mailing Address - Country:US
Mailing Address - Phone:615-631-7667
Mailing Address - Fax:
Practice Address - Street 1:1810 WARD DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0560
Practice Address - Country:US
Practice Address - Phone:615-895-6942
Practice Address - Fax:615-867-6314
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPE-1601103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical