Healthcare Provider Details

I. General information

NPI: 1447877543
Provider Name (Legal Business Name): KATHERINE TAYLOR ED.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 E 107TH ST
CARMEL IN
46280-1105
US

IV. Provider business mailing address

2352 S LOGAN DR
NEW PALESTINE IN
46163-8667
US

V. Phone/Fax

Practice location:
  • Phone: 317-331-2824
  • Fax:
Mailing address:
  • Phone: 585-474-7617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number10327692
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: