Individual
DR. PENNISSI P TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
205 CENTER AVENUE, BROWNWOOD, TX 76801-2919
(325) 649-4357
(325) 646-0919
Mailing address
PO BOX 1391, BROWNWOOD, TX 76804-1391
(325) 649-4357
(325) 646-0919
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
15762
TX
103TS0200X
School Psychologist
31191
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203875
VALUE OPTIONS
TX
01
—
87411A
BCBS
TX
Enumeration date
02/21/2007
Last updated
12/02/2024
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