Provider Demographics
NPI:1912563073
Name:ARNOLD, TAYLOR (PHD, RDN)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:PHD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 N BLUE MARLIN DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2607
Mailing Address - Country:US
Mailing Address - Phone:480-251-9202
Mailing Address - Fax:
Practice Address - Street 1:1341 N BLUE MARLIN DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2607
Practice Address - Country:US
Practice Address - Phone:480-251-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ86076164133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ86076164OtherCOMMISSION ON DIETETIC REGISTRATION