Provider Demographics
NPI:1750058483
Name:CHANEY, TAYLAR
Entity Type:Individual
Prefix:
First Name:TAYLAR
Middle Name:
Last Name:CHANEY
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 1:100 HUSKIES WAY
Mailing Address - Street 2:
Mailing Address - City:CADIZ
Mailing Address - State:OH
Mailing Address - Zip Code:43907-1257
Mailing Address - Country:US
Mailing Address - Phone:740-491-1994
Mailing Address - Fax:
Practice Address - Street 1:100 HUSKIES WAY
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:OH
Practice Address - Zip Code:43907-1257
Practice Address - Country:US
Practice Address - Phone:740-491-1994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011694225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist