Provider Demographics
NPI:1477824555
Name:TAYLOR, AMBER (SLPA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 CAMDEN ST STE 108
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-2430
Mailing Address - Country:US
Mailing Address - Phone:207-593-0709
Mailing Address - Fax:
Practice Address - Street 1:91 CAMDEN ST STE 108
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2430
Practice Address - Country:US
Practice Address - Phone:207-593-0709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESAS 21462355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant