MEDICARE: TAYLOR ALEXIS DILLON M.S., CF-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1225612617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR ALEXIS DILLON M.S., CF-SLP

Provider Business Mailing Address
First Line	:	1862 N SCULL CREEK DR
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-2316
Country	:	US
Telephone Number	:	501-786-1318
Fax Number	:

Provider Business Practice Location Address
First Line	:	2808 W WALNUT ST
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72756-0335
Country	:	US
Telephone Number	:	479-621-6126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2021
Last Update Date	:	05/11/2021

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