Provider Demographics
NPI:1659667426
Name:TAYLOR, CHELSEA (SLP)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 SIDNEY BAKER ST S STE 103
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5980
Mailing Address - Country:US
Mailing Address - Phone:830-896-3130
Mailing Address - Fax:830-896-3132
Practice Address - Street 1:448 SIDNEY BAKER ST S STE 103
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5980
Practice Address - Country:US
Practice Address - Phone:830-896-3130
Practice Address - Fax:830-896-3132
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108769235Z00000X
MSS3568235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist