Provider Demographics
NPI:1003456187
Name:TAYLOR, LINDA D (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:D
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:PHILLIPS
Mailing Address - State:ME
Mailing Address - Zip Code:04966-0158
Mailing Address - Country:US
Mailing Address - Phone:207-779-7280
Mailing Address - Fax:
Practice Address - Street 1:117 AUBURN RD
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:ME
Practice Address - Zip Code:04290-3024
Practice Address - Country:US
Practice Address - Phone:207-562-4207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESAS30162355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant