Healthcare Provider Details

I. General information

NPI: 1578054839
Provider Name (Legal Business Name): KARA MARIE TAYLOR AU.D. CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2295 HENRY TECKLENBURG DR
CHARLESTON SC
29414-7801
US

IV. Provider business mailing address

2295 HENRY TECKLENBURG DR
CHARLESTON SC
29414-7801
US

V. Phone/Fax

Practice location:
  • Phone: 843-766-7103
  • Fax:
Mailing address:
  • Phone: 843-766-7103
  • Fax: 843-377-4629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number8039
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: