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General NPI Number Information
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NPI Number | 1487146940
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Entity Type | Individual
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Provider Name | TAYLOR DIGRAVINA PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/31/2018
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 2 INDUSTRIAL WAY W STE 203
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City | EATONTOWN
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State | NJ
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Zip | 07724-2266
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Country | US
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Telephone | 732-982-2888
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 N SCOTTSDALE RD STE 2500
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7630
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Country | US
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Telephone | 732-982-2888
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PS-018440
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 35SI00681700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS-018440
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35SI00681700
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35SI00681700
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License Number State | NJ
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