Healthcare Provider Details

I. General information

NPI: 1093149015
Provider Name (Legal Business Name): KRISTEN M TAYLOR MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3285 S COUNTY TRL UNIT 2B
EAST GREENWICH RI
02818-1469
US

IV. Provider business mailing address

3285 S COUNTY TRL UNIT 2B
EAST GREENWICH RI
02818-1469
US

V. Phone/Fax

Practice location:
  • Phone: 401-404-5585
  • Fax:
Mailing address:
  • Phone: 401-404-5585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP01200
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: