Provider Demographics
NPI:1003705534
Name:TAYLOR, KATHRYN GRACE (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:GRACE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CRISANTO AVE STE A
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-6272
Mailing Address - Country:US
Mailing Address - Phone:803-746-4655
Mailing Address - Fax:
Practice Address - Street 1:130 CRISANTO AVE STE A
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-6272
Practice Address - Country:US
Practice Address - Phone:803-487-5638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7645225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist