Provider Demographics
NPI:1629556758
Name:EDINBURGH-TAYLOR, MAYA NICOLETTE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:NICOLETTE
Last Name:EDINBURGH-TAYLOR
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MAYA
Other - Middle Name:NICOLETTE
Other - Last Name:EDINBURGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2015 BOUNDARY ST STE 226
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6802
Mailing Address - Country:US
Mailing Address - Phone:843-868-1110
Mailing Address - Fax:843-594-0849
Practice Address - Street 1:2015 BOUNDARY ST STE 226
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-6802
Practice Address - Country:US
Practice Address - Phone:843-868-1110
Practice Address - Fax:843-594-0849
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7530235Z00000X
CA27216235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist