Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
Y | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TC1900X | Counseling Psychologist | ||
N | 103TP0814X | Psychoanalysis | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1366039463 |
---|---|
Provider Name | Debra Taylor |
First Address | Indianapolis, IN 46226-3159 |
Second Address | Indianapolis, IN 46226-3159 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2020 |
Last Update Date | 23/12/2020 |