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Individual

DR. GAVIN HENDERSON TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.CLIN.PSY.

Contact information

Practice address
20 CENTURY HILL DR, SUITE 202, LATHAM, NY 12110-2116
(518) 785-7283
Mailing address
20 CENTURY HILL DR, SUITE 202, LATHAM, NY 12110-2116

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
019877-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1215152962
PRACTICE NPI
NY
Enumeration date
11/12/2012
Last updated
11/19/2012
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