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General NPI Number Information
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NPI Number | 1528634482
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Entity Type | Individual
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Provider Name | KATHERINE TAGGART
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Gender | Female
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Dates
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Enumeration Date | 06/01/2021
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Last Update Date | 03/03/2024
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Provider Practice Location Address
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Address Line | 122 MORVEN PARK RD NW
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City | LEESBURG
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State | VA
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Zip | 20176-2024
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Country | US
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Telephone | 571-271-4475
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Fax |
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Provider Business Mailing Address
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Address Line | 21543 WELBY TER
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City | BROADLANDS
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State | VA
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Zip | 20148-5049
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Country | US
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Telephone |
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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 | 2202008596
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License Number State | VA
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