Provider Demographics
NPI:1336658061
Name:SHINHOLT, TAYLOR (OTR/L)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:SHINHOLT
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 1:115 SUDBROOK LN STE A
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4184
Mailing Address - Country:US
Mailing Address - Phone:410-358-1997
Mailing Address - Fax:866-840-6040
Practice Address - Street 1:801 N BROADWAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-1424
Practice Address - Country:US
Practice Address - Phone:443-923-9290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08284225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist