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NPI Code Detail

MEDICARE: MARISSA TAYLOR

MEDICARE: MARISSA TAYLOR
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 Pathologist

General Provider Information

NPI Number : 1801510193
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA TAYLOR
Provider Business Mailing Address
First Line : 400 SOUTHERN CROSS DR APT 11
Second Line :
City : RICHMOND
State : KY
Zip : 40475-7041
Country : US
Telephone Number : 606-794-2461
Fax Number :
Provider Business Practice Location Address
First Line : 105 HARMON HTS
Second Line :
City : STANFORD
State : KY
Zip : 40484-1111
Country : US
Telephone Number : 606-365-2141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2022
Last Update Date : 09/29/2022

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Directions to “ MARISSA TAYLOR ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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