Provider Demographics
NPI:1437648367
Name:TAYLOR, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:TAYLOR
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 1:163 HIGHLAND HILL RD
Mailing Address - Street 2:
Mailing Address - City:BIG ROCK
Mailing Address - State:TN
Mailing Address - Zip Code:37023-3095
Mailing Address - Country:US
Mailing Address - Phone:931-801-8103
Mailing Address - Fax:
Practice Address - Street 1:163 HIGHLAND HILL RD
Practice Address - Street 2:
Practice Address - City:BIG ROCK
Practice Address - State:TN
Practice Address - Zip Code:37023-3095
Practice Address - Country:US
Practice Address - Phone:931-801-8103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist