Provider Demographics
NPI:1538575238
Name:COUNCE, TAYLOR A
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:A
Last Name:COUNCE
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 1:1218 STONE ST STE 140
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4568
Mailing Address - Country:US
Mailing Address - Phone:870-336-0220
Mailing Address - Fax:870-558-5637
Practice Address - Street 1:1218 STONE ST STE 140
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4568
Practice Address - Country:US
Practice Address - Phone:870-336-0220
Practice Address - Fax:870-558-5637
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
AROTA1503224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No171M00000XOther Service ProvidersCase Manager/Care Coordinator