Provider Demographics
NPI:1609118546
Name:TAYLOR, KRISTY L (SLP)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:L
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:6005 WESTVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055
Mailing Address - Country:US
Mailing Address - Phone:713-696-2130
Mailing Address - Fax:713-696-2133
Practice Address - Street 1:6005 WESTVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055
Practice Address - Country:US
Practice Address - Phone:713-696-2130
Practice Address - Fax:713-696-2133
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-19
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108503235Z00000X
TN4324235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist