Healthcare Provider Details

I. General information

NPI: 1689090318
Provider Name (Legal Business Name): TAYLOR MASON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2014
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1666 MASSACHUSETTS AVE STE 1718
LEXINGTON MA
02420-5317
US

IV. Provider business mailing address

7 HELENA DR
TYNGSBORO MA
01879-1065
US

V. Phone/Fax

Practice location:
  • Phone: 781-861-0695
  • Fax:
Mailing address:
  • Phone: 978-877-7541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10714
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number10714
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: