Provider Demographics
NPI:1437728128
Name:BROWN, TAYLOR NOELLE (LMT, OTR)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NOELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01036-9542
Mailing Address - Country:US
Mailing Address - Phone:413-355-0628
Mailing Address - Fax:
Practice Address - Street 1:11 SAINT ANTHONY ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01013-2141
Practice Address - Country:US
Practice Address - Phone:413-315-4205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12990225700000X
CT5728225X00000X
MA13999225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist