Provider Demographics
NPI:1710281449
Name:TAGGART, MICHELLE MINER (MS/CCC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MINER
Last Name:TAGGART
Suffix:
Gender:F
Credentials:MS/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 STELLARIA CIR
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-2215
Mailing Address - Country:US
Mailing Address - Phone:801-232-6823
Mailing Address - Fax:
Practice Address - Street 1:1353 STELLARIA CIR
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-2215
Practice Address - Country:US
Practice Address - Phone:801-232-6823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT110454-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist