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NPI Code Detail

MEDICARE: TAYLOR N CREECH MA CCC-SLP

MEDICARE: TAYLOR N CREECH MA CCC-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
1235Z00000XSpeech-Language PathologistSP.12982OH

General Provider Information

NPI Number : 1245709096
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR N CREECH MA CCC-SLP
Provider Business Mailing Address
First Line : 1015 PRINCEWOOD AVE APT C
Second Line :
City : DAYTON
State : OH
Zip : 45429-5875
Country : US
Telephone Number : 937-829-5633
Fax Number :
Provider Business Practice Location Address
First Line : 5070 LAMME RD
Second Line :
City : MORAINE
State : OH
Zip : 45439-3266
Country : US
Telephone Number : 937-293-7703
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2018
Last Update Date : 11/21/2018

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Directions to “ TAYLOR N CREECH MA CCC-SLP” Practice Location

Language Start Address Practice Location
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