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General NPI Number Information
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NPI Number | 1710860846
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Entity Type | Individual
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Provider Name | TAYLOR PHELPS
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Gender | Female
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 601 W BURKHART ST
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City | MALDEN
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State | MO
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Zip | 63863-1440
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Country | US
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Telephone | 573-276-5794
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Fax |
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Provider Business Mailing Address
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Address Line | 8781 COUNTY ROAD 629
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City | QULIN
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State | MO
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Zip | 63961-8226
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Country | US
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Telephone | 573-429-1373
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2024044474
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License Number State | MO
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