Provider Demographics
NPI:1689372377
Name:HENSLEY, TAYLOR NEILL
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NEILL
Last Name:HENSLEY
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 1:1001 GRAND AVE UNIT 5
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-3642
Mailing Address - Country:US
Mailing Address - Phone:970-665-4744
Mailing Address - Fax:970-549-2874
Practice Address - Street 1:1001 GRAND AVE UNIT 5
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-3642
Practice Address - Country:US
Practice Address - Phone:970-665-4744
Practice Address - Fax:970-549-2874
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOTA.0001646224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant