Healthcare Provider Details

I. General information

NPI: 1922500958
Provider Name (Legal Business Name): CYNTHIA LEE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12225 GREENVILLE AVE
DALLAS TX
75243-9362
US

IV. Provider business mailing address

12225 GREENVILLE AVE STE 600
DALLAS TX
75243-9362
US

V. Phone/Fax

Practice location:
  • Phone: 214-575-9820
  • Fax:
Mailing address:
  • Phone: 214-575-9820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: