Provider Demographics
NPI:1609668490
Name:TAYLOR, BLAIR M (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:BLAIR
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
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 1:36550 CHESTER RD APT 707
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4000
Mailing Address - Country:US
Mailing Address - Phone:440-409-1698
Mailing Address - Fax:
Practice Address - Street 1:36550 CHESTER RD APT 707
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-4000
Practice Address - Country:US
Practice Address - Phone:440-409-1698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.15222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist