Healthcare Provider Details

I. General information

NPI: 1093531659
Provider Name (Legal Business Name): EMILY TAYLOR CLAPSADDLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2024
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 BELLVUE ST
UNION BRIDGE MD
21791-9179
US

IV. Provider business mailing address

102 BELLVUE ST
UNION BRIDGE MD
21791-9179
US

V. Phone/Fax

Practice location:
  • Phone: 443-523-4685
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberA0001775
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: