Individual
MS. ROBERTA K TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNCS
Contact information
Practice address
1 WASHINGTON ST, WELLESLEY, MA 02481-1711
(781) 330-3855
Mailing address
274 BISHOPS FOREST DR, WALTHAM, MA 02452-8808
(781) 894-5640
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
116369
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022133
ANCC CERTIFICATION
MA
01
—
116369
NURSING LICENSE
MA
01
—
PN0039
BCBS PROVIDER #
MA
Enumeration date
02/04/2007
Last updated
07/21/2022
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