Provider Demographics
NPI:1326384389
Name:TAYLOR, DINA M
Entity Type:Individual
Prefix:MS
First Name:DINA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6805 ENCHANTED VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1778
Mailing Address - Country:US
Mailing Address - Phone:775-624-1011
Mailing Address - Fax:
Practice Address - Street 1:505 S ARLINGTON AVE
Practice Address - Street 2:#106
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-1527
Practice Address - Country:US
Practice Address - Phone:775-324-4820
Practice Address - Fax:775-324-5840
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner