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General NPI Number Information
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NPI Number | 1063983070
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Entity Type | Individual
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Provider Name | REBECCA TAYLOR CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 12/04/2019
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Provider Practice Location Address
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Address Line | 14410 TERRACE RD
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City | CLEVELAND
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State | OH
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Zip | 44112-3928
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Country | US
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Telephone | 216-268-6610
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Fax |
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Provider Business Mailing Address
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Address Line | 11209 LAKE AVE APT 5
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City | CLEVELAND
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State | OH
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Zip | 44102-6154
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Country | US
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Telephone | 724-961-3581
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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 | 08894
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP.13532
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License Number State | OH
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