Provider Demographics
NPI:1922368158
Name:TAYLOR, LINDA D (IECE)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:D
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:IECE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 MAYS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033-8675
Mailing Address - Country:US
Mailing Address - Phone:270-465-1623
Mailing Address - Fax:
Practice Address - Street 1:205 MAYS CHAPEL RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-8675
Practice Address - Country:US
Practice Address - Phone:270-465-1623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY03OtherDEVELOPMENTAL INTERVENTIOIST