Provider Demographics
NPI:1972250793
Name:TAYLOR, FAITH KATHERINE (OT)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:KATHERINE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-1827
Mailing Address - Country:US
Mailing Address - Phone:734-263-2493
Mailing Address - Fax:734-661-0410
Practice Address - Street 1:4121 JACKSON RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-1827
Practice Address - Country:US
Practice Address - Phone:734-263-2493
Practice Address - Fax:734-661-0410
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201011317225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist