Provider Demographics
NPI:1245501097
Name:TAYLOR, PAUL JAMES (MA, CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JAMES
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4622 BROOK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49690-8201
Mailing Address - Country:US
Mailing Address - Phone:231-928-0763
Mailing Address - Fax:
Practice Address - Street 1:4543 S M 88 HWY
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:MI
Practice Address - Zip Code:49615-9109
Practice Address - Country:US
Practice Address - Phone:231-533-8661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist