Healthcare Provider Details

I. General information

NPI: 1679568208
Provider Name (Legal Business Name): JENNIFER TAYLOR-GUY AUD., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 12/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 DAUPHIN ST
MOBILE AL
36608-1756
US

IV. Provider business mailing address

2880 DAUPHIN ST
MOBILE AL
36606-2457
US

V. Phone/Fax

Practice location:
  • Phone: 251-341-3368
  • Fax: 251-341-3371
Mailing address:
  • Phone: 251-341-3368
  • Fax: 251-341-3371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number844-A
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number844-A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: