Provider Demographics
NPI:1891464012
Name:KRAFT, TAYLOR (MS-CCC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:KRAFT
Suffix:
Gender:F
Credentials:MS-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:858 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-5853
Mailing Address - Country:US
Mailing Address - Phone:972-672-6602
Mailing Address - Fax:
Practice Address - Street 1:1820 PEARL ST BLDG C
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-6120
Practice Address - Country:US
Practice Address - Phone:972-968-5833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118404235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist