Provider Demographics
NPI:1902573314
Name:KALKBRENNER, TAYLOR ALEXIS
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ALEXIS
Last Name:KALKBRENNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CAPISTRANO CT APT 204
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-6181
Mailing Address - Country:US
Mailing Address - Phone:412-735-1445
Mailing Address - Fax:
Practice Address - Street 1:125 N COURT ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5192
Practice Address - Country:US
Practice Address - Phone:410-751-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02333L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist