Provider Demographics
NPI:1912682832
Name:MOORE, TAYLOR NORTON (OTR/L)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NORTON
Last Name:MOORE
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 1:4 RED FOX RUN
Mailing Address - Street 2:
Mailing Address - City:SHOAL CREEK
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5942
Mailing Address - Country:US
Mailing Address - Phone:205-396-8721
Mailing Address - Fax:
Practice Address - Street 1:405 E DR HICKS BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5762
Practice Address - Country:US
Practice Address - Phone:256-767-1576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6145225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics