Provider Demographics
NPI:1659023158
Name:YODER, TAYLOR (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:YODER
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7344 SHELBOURNE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-3012
Mailing Address - Country:US
Mailing Address - Phone:215-237-3896
Mailing Address - Fax:
Practice Address - Street 1:8 E MILL RD
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-2027
Practice Address - Country:US
Practice Address - Phone:215-392-9911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006077133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered