Provider Demographics
NPI:1174680946
Name:TAYLOR, PAULETTE (MS)
Entity Type:Individual
Prefix:
First Name:PAULETTE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:PAULETTE
Other - Middle Name:
Other - Last Name:TAYLOR-YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9004 LINCOLN DR W
Mailing Address - Street 2:SUITE F
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3206
Mailing Address - Country:US
Mailing Address - Phone:856-988-1160
Mailing Address - Fax:856-988-1183
Practice Address - Street 1:9004 LINCOLN DR W
Practice Address - Street 2:SUITE F
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3206
Practice Address - Country:US
Practice Address - Phone:856-988-1160
Practice Address - Fax:856-988-1183
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00275800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist