MEDICARE: SHELLEY A TAYLOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist		MI

General Provider Information

NPI Number	:	1134625759
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHELLEY A TAYLOR

Provider Business Mailing Address
First Line	:	248 WOODED VALLEY DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49696-8731
Country	:	US
Telephone Number	:	248-672-9275
Fax Number	:

Provider Business Practice Location Address
First Line	:	248 WOODED VALLEY DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49696-8731
Country	:	US
Telephone Number	:	248-672-9275
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHELLEY ANN TAYLOR
Credential	:	M.A., L.L.P., LLC
Telephone Number	:	248-672-9275

Provider Enumeration Date	:	04/03/2018
Last Update Date	:	07/17/2025

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Directions to “SHELLEY A TAYLOR ” Practice Location

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