Provider Demographics
NPI:1881196772
Name:HARTMAN, TAYLOR ANN
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANN
Last Name:HARTMAN
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 1:5414 HIGHRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HALETHORPE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-2732
Mailing Address - Country:US
Mailing Address - Phone:410-300-0567
Mailing Address - Fax:
Practice Address - Street 1:5414 HIGHRIDGE ST
Practice Address - Street 2:
Practice Address - City:HALETHORPE
Practice Address - State:MD
Practice Address - Zip Code:21227-2732
Practice Address - Country:US
Practice Address - Phone:410-300-0567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician