Organization
PHILIP R. TAFT PSY.D. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP RAYMOND TAFT PSY.D. (CLINICAL PSYCHOLOGIST &MANAGER)
(903) 872-4442
Entity
Organization
Contact information
Practice address
715 W 2ND AVE, CORSICANA, TX 75110-3012
(903) 872-4442
(903) 642-2550
Mailing address
1106 OAKLAWN DR, CORSICANA, TX 75110-2848
(903) 872-4442
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0073MG
BLUE CROSS BLUE SHIELD TX
TX
Enumeration date
01/21/2008
Last updated
07/06/2024
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