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Individual

ALICEN STEGALL TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4801 TROUP HWY, SUITE 800, TYLER, TX 75703-2356
(903) 939-2800
(817) 789-6849
Mailing address
5316 TRAIL LAKE DR, FORT WORTH, TX 76133-1931
(817) 292-8787
(817) 789-6849

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
108247
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149984001
TX
05
207164901
TX
Enumeration date
09/11/2012
Last updated
09/11/2012
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