Provider Demographics
NPI:1235436221
Name:TAYLOR, LEAH BUTLER (MOTR/L, CLT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:BUTLER
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MOTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 CROSS POINT RD
Mailing Address - Street 2:
Mailing Address - City:EDGECOMB
Mailing Address - State:ME
Mailing Address - Zip Code:04556-3217
Mailing Address - Country:US
Mailing Address - Phone:207-350-1504
Mailing Address - Fax:
Practice Address - Street 1:35 MILES ST
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543-4047
Practice Address - Country:US
Practice Address - Phone:207-536-4817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2508225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist