Provider Demographics
NPI:1881824126
Name:TAYLOR, KATIE L (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04443-6315
Mailing Address - Country:US
Mailing Address - Phone:207-876-4635
Mailing Address - Fax:207-876-4363
Practice Address - Street 1:13385 W MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2631
Practice Address - Country:US
Practice Address - Phone:623-986-5110
Practice Address - Fax:623-207-9683
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1382225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist