Healthcare Provider Details

I. General information

NPI: 1609374602
Provider Name (Legal Business Name): TAYLOR S MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAYLOR J STRONG SLP

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 01/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 HWY 80 EAST STE 3
CLINTON MS
39056-4726
US

IV. Provider business mailing address

DANA BLAIR - PERFORMANCE THERAPY PO BOX 890
MADISON MS
39130-0890
US

V. Phone/Fax

Practice location:
  • Phone: 601-460-0910
  • Fax:
Mailing address:
  • Phone: 601-278-7526
  • Fax: 601-898-3699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberS4322
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberS4322
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: