Provider Demographics
NPI:1598051039
Name:NEAL, EMMA TAYLOR (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:TAYLOR
Last Name:NEAL
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 E MILKY WAY DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-1515
Mailing Address - Country:US
Mailing Address - Phone:716-479-6708
Mailing Address - Fax:406-792-8016
Practice Address - Street 1:608 E MILKY WAY DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047
Practice Address - Country:US
Practice Address - Phone:716-479-6708
Practice Address - Fax:406-792-8016
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2631225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics