Healthcare Provider Details

I. General information

NPI: 1376462275
Provider Name (Legal Business Name): TAYLOR MACKENZIE BECKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 HUBBARD RD
MADISON OH
44057-2565
US

IV. Provider business mailing address

33446 LISA LN
SOLON OH
44139-6102
US

V. Phone/Fax

Practice location:
  • Phone: 440-428-2664
  • Fax:
Mailing address:
  • Phone: 440-221-6816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number20263549
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: