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General NPI Number Information
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NPI Number | 1255148953
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Entity Type | Individual
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Provider Name | ABBY TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 151 SOUTHWEST DR
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City | JONESBORO
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State | AR
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Zip | 72401-5828
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Country | US
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Telephone | 870-932-0090
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Fax | 870-930-9336
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Provider Business Mailing Address
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Address Line | 125 HAYES ST UNIT 3A
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City | BROOKLAND
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State | AR
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Zip | 72417-9127
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Country | US
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Telephone | 870-656-9100
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Fax | 870-930-9336
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA2083
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License Number State | AR
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