Provider Demographics
NPI:1851975809
Name:HENSIEK, TAYLOR BRIANNE (DPT)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:BRIANNE
Last Name:HENSIEK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6009 JAMIESON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-3302
Mailing Address - Country:US
Mailing Address - Phone:636-352-9229
Mailing Address - Fax:
Practice Address - Street 1:6009 JAMIESON AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-3302
Practice Address - Country:US
Practice Address - Phone:636-352-9229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021006158225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist