Provider Demographics
NPI:1518489103
Name:MOREE, TAYLOR (RD, LD, LMBT)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:MOREE
Suffix:
Gender:F
Credentials:RD, LD, LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4508
Mailing Address - Country:US
Mailing Address - Phone:336-262-0851
Mailing Address - Fax:
Practice Address - Street 1:807 MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-4213
Practice Address - Country:US
Practice Address - Phone:336-262-0851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD004907133V00000X
NC8759225700000X
NCL005341133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist