Provider Demographics
NPI:1154478501
Name:TAYLOR, DEBRA R (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:R
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 FOREST DRIVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403
Mailing Address - Country:US
Mailing Address - Phone:410-280-8774
Mailing Address - Fax:410-267-1995
Practice Address - Street 1:1419 FOREST DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403
Practice Address - Country:US
Practice Address - Phone:410-280-8774
Practice Address - Fax:410-267-1995
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02570225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLY24CHOtherBLUE CROSS BLUE SHIELD