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Individual

MRS. CARRIE W TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
6211 MULLEN RD SE, LACEY, WA 98503-7146
(360) 412-4600
Mailing address
6434 JEFFREY CT SE, LACEY, WA 98513-6531
(707) 490-4811

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60868497
WA
235Z00000X
Speech-Language Pathologist
SP18878
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12133177
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
01
LL60868497
WASHINGTON STATE SPEECH LANGUAGE PATHOLOGY LICENSE
WA
Enumeration date
10/14/2018
Last updated
10/14/2018
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