Provider Demographics
NPI:1457152597
Name:MURPHY, TAYLOR (COTA)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:MURPHY
Suffix:
Gender:
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 WESTCOTT BLVD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-9043
Mailing Address - Country:US
Mailing Address - Phone:843-900-4850
Mailing Address - Fax:
Practice Address - Street 1:5130 WESTCOTT BLVD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-9043
Practice Address - Country:US
Practice Address - Phone:843-480-8439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5706224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant