Provider Demographics
NPI:1578824165
Name:TAYLOR, ANNABELLE (LPTA, CFO)
Entity Type:Individual
Prefix:MRS
First Name:ANNABELLE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPTA, CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21100 GOLDEN OAKS LN
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63383-6273
Mailing Address - Country:US
Mailing Address - Phone:314-306-5652
Mailing Address - Fax:
Practice Address - Street 1:615 RANCHO LN
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-1717
Practice Address - Country:US
Practice Address - Phone:314-839-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116573225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant