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General NPI Number Information
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NPI Number | 1891122917
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Entity Type | Individual
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Provider Name | LINDA JEAN TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 10/03/2013
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 5535 S WILLIAMSON BLVD STE 774
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City | PORT ORANGE
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State | FL
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Zip | 32128-8311
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Country | US
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Telephone | 800-330-7711
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Fax | 866-426-2811
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Provider Business Mailing Address
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Address Line | 7854 QUEENIE CT
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City | ALLENDALE
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State | MI
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Zip | 49401-8058
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 057003823
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License Number State | IL
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