Provider Demographics
NPI:1205293677
Name:CALHOUN, TAYLOR (COTA)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 WHITEHALL DR APT 405
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-1063
Mailing Address - Country:US
Mailing Address - Phone:561-847-6740
Mailing Address - Fax:
Practice Address - Street 1:3636 WHITEHALL DR APT 405
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-1063
Practice Address - Country:US
Practice Address - Phone:561-847-6740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA14887224Z00000X
TX213722224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant