Provider Demographics
NPI:1548814908
Name:TAYLOR, EMILY E (RDN/LD)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RDN/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 SHORELINE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-0130
Mailing Address - Country:US
Mailing Address - Phone:855-383-1240
Mailing Address - Fax:855-383-1241
Practice Address - Street 1:2800 SHORELINE DR STE 120
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0130
Practice Address - Country:US
Practice Address - Phone:855-383-1240
Practice Address - Fax:855-383-1241
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT03001133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty