Provider Demographics
NPI:1225263908
Name:TAYLOE, AINSLEY SMITH (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AINSLEY
Middle Name:SMITH
Last Name:TAYLOE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8703 HIGHWAY 17 BYP S
Mailing Address - Street 2:SUITE I
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29575-7701
Mailing Address - Country:US
Mailing Address - Phone:843-457-1053
Mailing Address - Fax:843-215-2910
Practice Address - Street 1:8703 HIGHWAY 17 BYP S
Practice Address - Street 2:SUITE I
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29575-7701
Practice Address - Country:US
Practice Address - Phone:843-457-1053
Practice Address - Fax:843-215-2910
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC7718235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist