Provider Demographics
NPI:1417635830
Name:POIRIER, TAYLOR JENAE (OTRL)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JENAE
Last Name:POIRIER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:988 W GERMAN RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-9642
Mailing Address - Country:US
Mailing Address - Phone:989-280-5585
Mailing Address - Fax:
Practice Address - Street 1:5815 BAY RD STE 400
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2542
Practice Address - Country:US
Practice Address - Phone:989-799-6885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist