Provider Demographics
NPI:1831411206
Name:TAYLOR, DONNA (MS-SLP)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16308 LEMOYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-5017
Mailing Address - Country:US
Mailing Address - Phone:228-392-1387
Mailing Address - Fax:228-392-6805
Practice Address - Street 1:16308 LEMOYNE BLVD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-5017
Practice Address - Country:US
Practice Address - Phone:228-392-1387
Practice Address - Fax:228-392-6805
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS203707235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist