Provider Demographics
NPI:1750505970
Name:TAYLOR, CHRISTINE (OTR)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 JAMISON DR
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-8483
Mailing Address - Country:US
Mailing Address - Phone:870-586-9506
Mailing Address - Fax:870-586-9506
Practice Address - Street 1:293 GREENE ROAD 606
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-9785
Practice Address - Country:US
Practice Address - Phone:870-240-4409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1402225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist