Provider Demographics
NPI:1205511748
Name:DENNIS, TAYLOR MORGAN (MED- CF SLP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MORGAN
Last Name:DENNIS
Suffix:
Gender:F
Credentials:MED- CF SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 CEDARCREST RD # RED
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-6213
Mailing Address - Country:US
Mailing Address - Phone:561-801-3148
Mailing Address - Fax:404-595-2422
Practice Address - Street 1:2151 CEDARCREST RD
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-6213
Practice Address - Country:US
Practice Address - Phone:561-801-3148
Practice Address - Fax:404-595-2422
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET003856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist