Provider Demographics
NPI:1255901419
Name:BURNS, TAYLER MARIE
Entity type:Individual
Prefix:
First Name:TAYLER
Middle Name:MARIE
Last Name:BURNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9341 CLOVER HILL RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-9614
Mailing Address - Country:US
Mailing Address - Phone:239-443-8316
Mailing Address - Fax:
Practice Address - Street 1:925 DUDLEY PIKE
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-8120
Practice Address - Country:US
Practice Address - Phone:859-360-3006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician