Healthcare Provider Details

I. General information

NPI: 1538063193
Provider Name (Legal Business Name): REBEKAH LYNN TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3058 N STATE RD
DAVISON MI
48423-3508
US

IV. Provider business mailing address

12246 E POTTER RD
DAVISON MI
48423-8147
US

V. Phone/Fax

Practice location:
  • Phone: 810-652-6315
  • Fax: 810-652-6213
Mailing address:
  • Phone: 248-881-7210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201013157
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: