Provider Demographics
NPI:1225486509
Name:TAYLOR, AYANTIE (RRT)
Entity Type:Individual
Prefix:
First Name:AYANTIE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4024 HAILEY CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-7314
Mailing Address - Country:US
Mailing Address - Phone:914-512-4821
Mailing Address - Fax:
Practice Address - Street 1:4024 HAILEY CRESCENT DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-7314
Practice Address - Country:US
Practice Address - Phone:914-512-4821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0117007944227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered