Individual
MS. MARY LOU TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
FROEDTERT & MED COLLEGE CLIN - EAST, 9200 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53226
(414) 805-3666
Mailing address
9200 W WISCONSIN AVE, FROEDTERT & MED COLLEGE CLIN - EAST, MILWAUKEE, WI 53226-3522
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1307
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39074000
—
WI
Enumeration date
05/15/2006
Last updated
11/12/2007
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