Individual
DR. MARCELLUS O TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
2998 VORTEC RD, MARIANNA, FL 32446-6734
(850) 209-2643
Mailing address
4428 LAFAYETTE ST, MARIANNA, FL 32446-3405
(850) 209-2643
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 5184
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59690
BCBS
FL
Enumeration date
03/31/2009
Last updated
03/31/2009
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