Provider Demographics
NPI:1891921490
Name:TAYLOR, JANET SUE (LMT, CLT)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:SUE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMT, CLT
Other - Prefix:MS
Other - First Name:JANET
Other - Middle Name:SUE
Other - Last Name:HAMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2665 VILLA CREEK DR
Mailing Address - Street 2:SUITE 121
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7309
Mailing Address - Country:US
Mailing Address - Phone:214-287-1366
Mailing Address - Fax:
Practice Address - Street 1:2665 VILLA CREEK DR
Practice Address - Street 2:SUITE 121
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7309
Practice Address - Country:US
Practice Address - Phone:214-287-1366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT014487225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist