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General NPI Number Information
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NPI Number | 1265908503
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Entity Type | Individual
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Provider Name | CARRIE W TAYLOR M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/14/2018
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Last Update Date | 10/14/2018
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Provider Practice Location Address
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Address Line | 6211 MULLEN RD SE
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City | LACEY
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State | WA
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Zip | 98503-7146
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Country | US
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Telephone | 360-412-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 6434 JEFFREY CT SE
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City | LACEY
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State | WA
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Zip | 98513-6531
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Country | US
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Telephone | 707-490-4811
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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 | SP18878
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License Number State | CA
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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 | LL60868497
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License Number State | WA
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