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NPI Code Detail

MEDICARE: TAYLOR BREEDLOVE SLP

MEDICARE: TAYLOR BREEDLOVE SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1497499933
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR BREEDLOVE SLP
Provider Business Mailing Address
First Line : 2190 S UECKER LN APT 128
Second Line :
City : LEWISVILLE
State : TX
Zip : 75067-7835
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4011 BENBROOK HWY STE C
Second Line :
City : FORT WORTH
State : TX
Zip : 76116-7800
Country : US
Telephone Number : 817-386-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2022
Last Update Date : 04/21/2022

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Directions to “ TAYLOR BREEDLOVE SLP” Practice Location

Language Start Address Practice Location
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