Provider Demographics
NPI:1194205518
Name:TAYLOR, LINDSAY BETH (MT-BC)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:BETH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:MRS
Other - First Name:LINDSAY
Other - Middle Name:BETH
Other - Last Name:NUCKOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT-BC
Mailing Address - Street 1:2121 WATERS MILL PT
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-2914
Mailing Address - Country:US
Mailing Address - Phone:434-964-7199
Mailing Address - Fax:
Practice Address - Street 1:520 EASTBROOK DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1135
Practice Address - Country:US
Practice Address - Phone:434-964-7199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA12058225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty