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General NPI Number Information
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NPI Number | 1013107945
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Entity Type | Individual
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Provider Name | TAMARA J TAYLOR MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 13025 W SAN MIGUEL AVE
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-9516
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Country | US
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Telephone | 623-217-2767
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Fax |
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Provider Business Mailing Address
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Address Line | 13025 W SAN MIGUEL AVE
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-9516
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Country | US
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Telephone | 623-217-2767
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP0291
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License Number State | AZ
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