Healthcare Provider Details

I. General information

NPI: 1073448692
Provider Name (Legal Business Name): TAYLOR HART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W ELLIOT RD STE 109
TEMPE AZ
85284-1310
US

IV. Provider business mailing address

4220 N 32ND ST UNIT 39
PHOENIX AZ
85018-4757
US

V. Phone/Fax

Practice location:
  • Phone: 480-374-4341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTH-010335
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: