Provider Demographics
NPI:1417571886
Name:MORRISON, TAYLOR (RDN, CSSD, LD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:RDN, CSSD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4429 HYER ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-1050
Mailing Address - Country:US
Mailing Address - Phone:901-830-3287
Mailing Address - Fax:
Practice Address - Street 1:4429 HYER ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-1050
Practice Address - Country:US
Practice Address - Phone:901-830-3287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81943133VN1501X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics