Provider Demographics
NPI:1700566460
Name:OSWALD, TAYLOR-RAE (OTR/L)
Entity Type:Individual
Prefix:
First Name:TAYLOR-RAE
Middle Name:
Last Name:OSWALD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 S BRONTE ST
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382-7429
Mailing Address - Country:US
Mailing Address - Phone:210-452-6003
Mailing Address - Fax:
Practice Address - Street 1:2423 S BRONTE ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382-7429
Practice Address - Country:US
Practice Address - Phone:210-452-6003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123865225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist