Provider Demographics
NPI:1306208863
Name:ABBEY, TAYLOR RAE
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:RAE
Last Name:ABBEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TAYLOR
Other - Middle Name:RAE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6444 N SILVERY LN
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2139
Mailing Address - Country:US
Mailing Address - Phone:734-546-1033
Mailing Address - Fax:
Practice Address - Street 1:6444 N SILVERY LN
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2139
Practice Address - Country:US
Practice Address - Phone:734-546-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other