Provider Demographics
NPI:1801468996
Name:TAYLOR, PRESLEY ROBINSON
Entity type:Individual
Prefix:
First Name:PRESLEY
Middle Name:ROBINSON
Last Name:TAYLOR
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 1:8017 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:TN
Mailing Address - Zip Code:38358-6805
Mailing Address - Country:US
Mailing Address - Phone:731-686-8373
Mailing Address - Fax:
Practice Address - Street 1:8017 DOGWOOD LN
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-6805
Practice Address - Country:US
Practice Address - Phone:731-686-8373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3572224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant