Provider Demographics
NPI:1366012734
Name:CHESNET, TAYLOR RAE (AUD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:RAE
Last Name:CHESNET
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 GORGAS LN
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2447
Mailing Address - Country:US
Mailing Address - Phone:484-889-9447
Mailing Address - Fax:
Practice Address - Street 1:460 CREAMERY WAY STE 103
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2533
Practice Address - Country:US
Practice Address - Phone:610-384-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00114500231H00000X
PAAT006774231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist