Provider Demographics
NPI:1205465358
Name:WINNERS, TAYLOR NOELLE (MSED, CCC-SLP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NOELLE
Last Name:WINNERS
Suffix:
Gender:F
Credentials:MSED, CCC-SLP
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:NOELLE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1430 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-3398
Mailing Address - Country:US
Mailing Address - Phone:308-870-1688
Mailing Address - Fax:
Practice Address - Street 1:2320 N COLORADO AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2286
Practice Address - Country:US
Practice Address - Phone:402-721-7710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14229935235Z00000X
NE2399235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist