MEDICARE: MS. TAYLOR STEPHANIE BANK 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
1	235Z00000X	Speech-Language Pathologist	109829	TX

General Provider Information

NPI Number	:	1750798229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TAYLOR STEPHANIE BANK CCC-SLP

Provider Business Mailing Address
First Line	:	13720 MIDWAY RD
Second Line	:	STE 107
City	:	DALLAS
State	:	TX
Zip	:	75244-4313
Country	:	US
Telephone Number	:	214-646-1449
Fax Number	:	214-699-8962

Provider Business Practice Location Address
First Line	:	13720 MIDWAY RD
Second Line	:	STE 107
City	:	DALLAS
State	:	TX
Zip	:	75244-4313
Country	:	US
Telephone Number	:	214-646-1449
Fax Number	:	214-699-8962

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

Provider Enumeration Date	:	07/16/2014
Last Update Date	:	07/16/2014

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Directions to “ MS. TAYLOR STEPHANIE BANK CCC-SLP” Practice Location

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