Healthcare Provider Details

I. General information

NPI: 1346872801
Provider Name (Legal Business Name): TAYLOR A MATTHEWS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2020
Last Update Date: 07/15/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 VT RTE 122
SHEFFIELD VT
05866-9446
US

IV. Provider business mailing address

2055 VT RTE 122
LYNDON CENTER VT
05850-9446
US

V. Phone/Fax

Practice location:
  • Phone: 603-716-7532
  • Fax:
Mailing address:
  • Phone: 603-716-7532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-43804
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: