Individual
BONNIE M TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, RN
Contact information
Practice address
1700 E 19TH ST, THE DALLES, OR 97058-3317
(541) 296-7760
(541) 296-7619
Mailing address
1700 E 19TH ST, THE DALLES, OR 97058-3317
(541) 296-7760
(541) 296-7619
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1613
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131275
—
OR
Enumeration date
07/27/2006
Last updated
11/19/2007
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