Provider Demographics
NPI:1053355123
Name:TAYLOR, PATRICIA A (MSED, ATC/L)
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSED, ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SPINNAKER RIDGE DR SW
Mailing Address - Street 2:B208
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35824-1365
Mailing Address - Country:US
Mailing Address - Phone:256-289-1104
Mailing Address - Fax:
Practice Address - Street 1:1963 MEMORIAL PKWY SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5036
Practice Address - Country:US
Practice Address - Phone:256-265-5000
Practice Address - Fax:256-265-7020
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11952255A2300X
FLAL20972255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer