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General NPI Number Information
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NPI Number | 1225220858
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Entity Type | Individual
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Provider Name | LETICIA ANN HOLUB TAYLOR PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 515 N MUR LEN RD
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City | OLATHE
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State | KS
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Zip | 66062-1267
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Country | US
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Telephone | 913-375-6273
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Fax |
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Provider Business Mailing Address
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Address Line | 12125 HORTON ST
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City | OVERLAND PARK
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State | KS
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Zip | 66209-2771
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Country | US
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Telephone | 913-375-6273
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Fax |
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 1284
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1284
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License Number State | KS
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