MEDICARE: DR. LEAH MARIE TAYLOR PSYD

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	06320	MD

General Provider Information

NPI Number	:	1275161507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEAH MARIE TAYLOR PSYD

Provider Business Mailing Address
First Line	:	615 STONE MILL CT
Second Line	:
City	:	ABINGDON
State	:	MD
Zip	:	21009-3217
Country	:	US
Telephone Number	:	954-214-9620
Fax Number	:

Provider Business Practice Location Address
First Line	:	10440 SHAKER DR STE 203
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-2346
Country	:	US
Telephone Number	:	410-740-2468
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2020
Last Update Date	:	03/31/2020

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