MEDICARE: DR. PEGGY SUE TAYLOR PSY.D

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	5335545-2501	UT

General Provider Information

NPI Number	:	1285846840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEGGY SUE TAYLOR PSY.D

Provider Business Mailing Address
First Line	:	PO BOX 418
Second Line	:
City	:	COLORADO CITY
State	:	AZ
Zip	:	86021-0418
Country	:	US
Telephone Number	:	435-900-1104
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 S COLVIN ST.
Second Line	:
City	:	COLORADO CITY
State	:	AZ
Zip	:	86021
Country	:	US
Telephone Number	:	435-900-1104
Fax Number	:

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

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	03/19/2025

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