Healthcare Provider Details

I. General information

NPI: 1861030066
Provider Name (Legal Business Name): TAYLAR F.M. HIRTE OTDR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2019
Last Update Date: 10/13/2023
Certification Date: 10/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 E LAKE MEAD PKWY STE 201
HENDERSON NV
89015-6443
US

IV. Provider business mailing address

98 E LAKE MEAD PKWY STE 201
HENDERSON NV
89015-6443
US

V. Phone/Fax

Practice location:
  • Phone: 702-433-3038
  • Fax:
Mailing address:
  • Phone: 702-433-3038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-3338
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: