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General NPI Number Information
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NPI Number | 1154161834
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Entity Type | Individual
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Provider Name | TAYLOR HOPE POLITTE CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/29/2024
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 1201 N ALTON ST
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City | LEBANON
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State | IL
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Zip | 62254-1103
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Country | US
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Telephone | 501-288-1998
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Fax |
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Provider Business Mailing Address
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Address Line | 280 CHARLES BASS RD
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City | BEEBE
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State | AR
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Zip | 72012-9618
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Country | US
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Telephone | 501-288-1998
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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 | 202107
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License Number State | AR
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