Provider Demographics
NPI:1659042786
Name:SHEEHAN, TAYLOR MARIE (DOCTOR OF AUDIOLOGY)
Entity Type:Individual
Prefix:MISS
First Name:TAYLOR
Middle Name:MARIE
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:DOCTOR OF AUDIOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:810 PLAZA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2762
Practice Address - Country:US
Practice Address - Phone:717-394-5088
Practice Address - Fax:717-394-5590
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT0006754231H00000X
237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAAT006754OtherLICENSE NUMBER