Provider Demographics
NPI:1326492968
Name:HORNBAKER, TAYLOR RAE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:RAE
Last Name:HORNBAKER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13410 BRADSHAW ST APT 33110
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4981
Mailing Address - Country:US
Mailing Address - Phone:785-307-1273
Mailing Address - Fax:
Practice Address - Street 1:13410 BRADSHAW ST APT 33110
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-4981
Practice Address - Country:US
Practice Address - Phone:785-307-1273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3680235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist