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General NPI Number Information
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NPI Number | 1760952972
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Entity Type | Individual
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Provider Name | SHAHEEN TAYLOR LMT
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Gender | Female
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Dates
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Enumeration Date | 11/29/2018
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Last Update Date | 11/29/2018
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Provider Practice Location Address
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Address Line | 210-B SOUTH CEDAR RIDGE DRIVE SUITE 200
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City | DUNCANVILLE
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State | TX
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Zip | 75116-4583
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Country | US
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Telephone | 469-866-1896
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Fax |
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Provider Business Mailing Address
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Address Line | 1509 KESWICK CT
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City | DESOTO
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State | TX
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Zip | 75115-1728
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Country | US
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Telephone | 469-990-4130
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT129372
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License Number State | TX
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