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General NPI Number Information
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NPI Number | 1992370456
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Entity Type | Organization
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Legal Business Name | EDWARD C. TAYLOR, PHD. PL
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Dates
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Enumeration Date | 05/26/2021
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Last Update Date | 05/26/2021
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Provider Practice Location Address
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Address Line | 8382 BAYMEADOWS RD STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7436
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Country | US
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Telephone | 904-886-9006
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Fax | 904-886-4060
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Provider Business Mailing Address
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Address Line | 8382 BAYMEADOWS RD STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7436
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Country | US
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Telephone | 904-886-9006
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Fax | 904-886-4060
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | STACY LEE SMITH
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Credential |
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Telephone | 904-886-9006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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