Provider Demographics
NPI:1053881565
Name:TAYLOR, ELENA JOY (OTR/L)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:JOY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:TN
Mailing Address - Zip Code:38358-3023
Mailing Address - Country:US
Mailing Address - Phone:325-280-3699
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:2076 S 2ND ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-3023
Practice Address - Country:US
Practice Address - Phone:325-280-3699
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6088225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist