Provider Demographics
NPI:1093043028
Name:TAYLOR, LISA K (MT-BC, NMT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:K
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MT-BC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ALLENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-2917
Mailing Address - Country:US
Mailing Address - Phone:949-735-5983
Mailing Address - Fax:
Practice Address - Street 1:110 ALLENWOOD LN
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-2917
Practice Address - Country:US
Practice Address - Phone:949-735-5983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist