Provider Demographics
NPI:1265211783
Name:MURPHY, TAYLOR RAE (OTR/L,CLT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:RAE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OTR/L,CLT
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:RAE
Other - Last Name:REPKING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L,CLT
Mailing Address - Street 1:1011 S PEMBROKE ST
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-3913
Mailing Address - Country:US
Mailing Address - Phone:217-691-5899
Mailing Address - Fax:
Practice Address - Street 1:738 18TH ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:IL
Practice Address - Zip Code:61920-2472
Practice Address - Country:US
Practice Address - Phone:217-512-2773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.010945225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist