Provider Demographics
NPI:1669795613
Name:TAYLOR, HALLIE E (CMT)
Entity type:Individual
Prefix:
First Name:HALLIE
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 COUNTY ROAD 507
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81122-9712
Mailing Address - Country:US
Mailing Address - Phone:970-403-4880
Mailing Address - Fax:
Practice Address - Street 1:1327 BAYFIELD PKWY STE C
Practice Address - Street 2:
Practice Address - City:BAYFIELD
Practice Address - State:CO
Practice Address - Zip Code:81122-5055
Practice Address - Country:US
Practice Address - Phone:970-403-4880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10089225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist