Provider Demographics
NPI:1639201106
Name:TAYLOR, DORIS JEAN
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:JEAN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 HAFELY DR
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-2340
Mailing Address - Country:US
Mailing Address - Phone:440-288-2527
Mailing Address - Fax:
Practice Address - Street 1:408 HAFELY DR
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-2340
Practice Address - Country:US
Practice Address - Phone:440-288-2527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other