Provider Demographics
NPI:1548858533
Name:BOWLING, TAYLOR (OT)
Entity type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:
Last Name:BOWLING
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-1223
Mailing Address - Country:US
Mailing Address - Phone:606-302-5474
Mailing Address - Fax:606-302-5418
Practice Address - Street 1:1510 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1223
Practice Address - Country:US
Practice Address - Phone:606-302-5474
Practice Address - Fax:606-302-5418
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY267945225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist