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NPI Code Detail

MEDICARE: JALYN DESTENE TAYLOR M.S., CCC-SLP

MEDICARE: JALYN DESTENE TAYLOR M.S., 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 PathologistSL015244PA

General Provider Information

NPI Number : 1396434262
Entity Type Code : Individual
Provider Name (Legal Business Name) : JALYN DESTENE TAYLOR M.S., CCC-SLP
Provider Business Mailing Address
First Line : 144 E LURAY ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19120-4425
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 E CATHEDRAL RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19128-1933
Country : US
Telephone Number : 215-487-1300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2023
Last Update Date : 05/04/2023

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Directions to “ JALYN DESTENE TAYLOR M.S., CCC-SLP” Practice Location

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