Healthcare Provider Details

I. General information

NPI: 1558939751
Provider Name (Legal Business Name): TAYLOR NEUHAUS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 MANZANA CT NW APT 2C
WALKER MI
49534-5779
US

IV. Provider business mailing address

34 MANZANA CT NW APT 2C
WALKER MI
49534-5779
US

V. Phone/Fax

Practice location:
  • Phone: 616-730-3280
  • Fax:
Mailing address:
  • Phone: 616-730-3280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7107007852
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.16725
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: