Healthcare Provider Details

I. General information

NPI: 1992940118
Provider Name (Legal Business Name): CYNTHIA ANN TAYLOR OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 04/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925A TURNBURY DR
GREENVILLE NC
27858-6168
US

IV. Provider business mailing address

1925A TURNBURY DR
GREENVILLE NC
27858-6168
US

V. Phone/Fax

Practice location:
  • Phone: 252-341-9944
  • Fax: 252-439-0957
Mailing address:
  • Phone: 252-341-9944
  • Fax: 252-439-0957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7055
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number7055
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number7055
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: