MEDICARE: KENNETH TAYNOR

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1306607585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH TAYNOR

Provider Business Mailing Address
First Line	:	6347 WELLINGTON PL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45424-4859
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6347 WELLINGTON PL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45424-4859
Country	:	US
Telephone Number	:	254-630-3950
Fax Number	:

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

Provider Enumeration Date	:	01/16/2024
Last Update Date	:	01/06/2026

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Directions to “ KENNETH TAYNOR ” Practice Location

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