Provider Demographics
NPI:1912599002
Name:PICANO, TAYLOR BELL (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:BELL
Last Name:PICANO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-1701
Mailing Address - Country:US
Mailing Address - Phone:810-599-8148
Mailing Address - Fax:
Practice Address - Street 1:100 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1899
Practice Address - Country:US
Practice Address - Phone:810-534-6101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101007155235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist