Provider Demographics
NPI:1235792813
Name:TAYLOR, HARLIE NICOLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:HARLIE
Middle Name:NICOLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 VETERANS HWY APT 509
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19056-2915
Mailing Address - Country:US
Mailing Address - Phone:215-310-8934
Mailing Address - Fax:
Practice Address - Street 1:2180 VETERANS HWY APT 509
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19056-2915
Practice Address - Country:US
Practice Address - Phone:215-310-8934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC016234225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist