MEDICARE: DR. DESIRE SHENAY TAYLOR PH.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	103TH0004X	Health Psychologist	37494	TX

General Provider Information

NPI Number	:	1659893816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DESIRE SHENAY TAYLOR PH.D.

Provider Business Mailing Address
First Line	:	5457 RICHARD AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-6713
Country	:	US
Telephone Number	:	512-963-1325
Fax Number	:

Provider Business Practice Location Address
First Line	:	4708 ALLIANCE BLVD STE 700
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-5317
Country	:	US
Telephone Number	:	469-814-4850
Fax Number	:	814-469-5678

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

Provider Enumeration Date	:	07/10/2017
Last Update Date	:	07/10/2017

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