Provider Demographics
NPI:1336705508
Name:STRATTON, TAYLOR LYNNE
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LYNNE
Last Name:STRATTON
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 1:1225 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:EAST ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62024-2161
Mailing Address - Country:US
Mailing Address - Phone:618-420-6436
Mailing Address - Fax:
Practice Address - Street 1:1021 W E ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-1055
Practice Address - Country:US
Practice Address - Phone:618-233-2095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist