Healthcare Provider Details

I. General information

NPI: 1093646432
Provider Name (Legal Business Name): MRS. TAYLOR BORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. TAYLOR HILL

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 E BLUELICK RD
LIMA OH
45801-2034
US

IV. Provider business mailing address

243 E BLUELICK RD
LIMA OH
45801-2034
US

V. Phone/Fax

Practice location:
  • Phone: 419-222-3339
  • Fax:
Mailing address:
  • Phone: 419-222-3339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2507397-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: