Healthcare Provider Details

I. General information

NPI: 1629998216
Provider Name (Legal Business Name): TAYLOR ELIZABETH FOX LMBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2122 N SHARON AMITY RD
CHARLOTTE NC
28205-7453
US

IV. Provider business mailing address

1210 CRYSTALWOOD CT NW
CONCORD NC
28027-2213
US

V. Phone/Fax

Practice location:
  • Phone: 513-498-4828
  • Fax:
Mailing address:
  • Phone: 513-498-4828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18014
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: