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General NPI Number Information
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NPI Number | 1194850370
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Entity Type | Individual
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Provider Name | PENNISSI P TAYLOR PH.D
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Gender | Female
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 205 CENTER AVENUE
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City | BROWNWOOD
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State | TX
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Zip | 76801-2919
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Country | US
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Telephone | 325-649-4357
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Fax | 325-646-0919
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Provider Business Mailing Address
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Address Line | PO BOX 1391
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City | BROWNWOOD
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State | TX
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Zip | 76804-1391
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Country | US
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Telephone | 325-649-4357
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Fax | 325-646-0919
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 31191
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 15762
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License Number State | TX
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