Provider Demographics
NPI:1932644887
Name:DEEDY, TAYLOR
Entity Type:Individual
Prefix:MISS
First Name:TAYLOR
Middle Name:
Last Name:DEEDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 SUFFOLK ST
Mailing Address - Street 2:APT 403
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-1625
Mailing Address - Country:US
Mailing Address - Phone:860-912-3792
Mailing Address - Fax:
Practice Address - Street 1:157 SUFFOLK ST
Practice Address - Street 2:APT 403
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-1625
Practice Address - Country:US
Practice Address - Phone:860-912-3792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist