Provider Demographics
NPI:1700232642
Name:TAYLOR, REBECCA (BA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02779-1504
Mailing Address - Country:US
Mailing Address - Phone:508-821-8340
Mailing Address - Fax:
Practice Address - Street 1:60 BROOK HAVEN DR APT 5
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-5130
Practice Address - Country:US
Practice Address - Phone:508-493-0571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-10
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool