Basic Information
Provider Information
NPI: 1083994610
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAYLOR
FirstName: CYNTHIA
MiddleName: L.
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10918 ELM AVE
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641344108
CountryCode: US
TelephoneNumber: 8167656600
FaxNumber: 8162516367
Practice Location
Address1: 10918 ELM AVE
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 64134
CountryCode: US
TelephoneNumber: 8167656600
FaxNumber: 8162516367
Other Information
ProviderEnumerationDate: 08/26/2011
LastUpdateDate: 08/09/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X2017024177MOY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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