Provider Demographics
NPI:1376182014
Name:TAYLOR, ASHERNITA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ASHERNITA
Middle Name:
Last Name:TAYLOR
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 1:2801 WELLS BRANCH PKWY APT 2438
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-6786
Mailing Address - Country:US
Mailing Address - Phone:512-202-9778
Mailing Address - Fax:
Practice Address - Street 1:3405 EL SALIDO PKWY
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5640
Practice Address - Country:US
Practice Address - Phone:572-402-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-28
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115863225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist