Provider Demographics
NPI:1376244459
Name:DEAN, TAYLOR ALEXIS
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ALEXIS
Last Name:DEAN
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 1:45841 CAREFREE WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-4378
Mailing Address - Country:US
Mailing Address - Phone:240-298-0700
Mailing Address - Fax:
Practice Address - Street 1:45841 CAREFREE WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-4378
Practice Address - Country:US
Practice Address - Phone:240-298-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant