Provider Demographics
NPI:1821872888
Name:LEDFORD, TAYLOR ELYSE
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELYSE
Last Name:LEDFORD
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 1:6012 OAK HOLLOW PL
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-8391
Mailing Address - Country:US
Mailing Address - Phone:903-556-0469
Mailing Address - Fax:
Practice Address - Street 1:751 RANKIN ST
Practice Address - Street 2:
Practice Address - City:ASHDOWN
Practice Address - State:AR
Practice Address - Zip Code:71822-3627
Practice Address - Country:US
Practice Address - Phone:870-898-3208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202358235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist