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NPI 1164112470

NPI 1164112470 : TAYLOR RAULERSON SLP : FORT WORTH, TX

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General NPI Number Information
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    NPI Number           |    1164112470
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    Entity Type          |    Individual 
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    Provider Name        |    TAYLOR RAULERSON SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/10/2023
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    Last Update Date     |    11/19/2025
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Provider Practice Location Address
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    Address Line         |    11751 ALTA VISTA RD STE 201 
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    City                 |    FORT WORTH
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    State                |    TX
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    Zip                  |    76244-6442
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    Country              |    US
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    Telephone            |    817-562-1006
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    Fax                  |    817-562-1009
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Provider Business Mailing Address
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    Address Line         |    6160 BENTRIDGE DR 
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    City                 |    HURST
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    State                |    TX
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    Zip                  |    76054-2615
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    Country              |    US
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    Telephone            |    817-479-7019
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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       |    119510
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    License Number State |    TX
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