Healthcare Provider Details

I. General information

NPI: 1700799400
Provider Name (Legal Business Name): AMY TAYLOR M.A., CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

752 RICHMOND RD N
BEREA KY
40403-1059
US

IV. Provider business mailing address

2713 BEE LICK RD
CRAB ORCHARD KY
40419-8038
US

V. Phone/Fax

Practice location:
  • Phone: 859-353-3666
  • Fax:
Mailing address:
  • Phone: 859-353-3666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number311205
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: