Provider Demographics
NPI:1861068306
Name:HERBERT, TAYLOR ANN (AUD)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANN
Last Name:HERBERT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:ANN
Other - Last Name:BAKAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:12240 ALLSPICE CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-1743
Mailing Address - Country:US
Mailing Address - Phone:717-286-8673
Mailing Address - Fax:
Practice Address - Street 1:9200 CHURCH ST STE 201
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5561
Practice Address - Country:US
Practice Address - Phone:571-646-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist