Taylor Thompson
Individual provider Active NPI Speech-Language Pathologist · Patton, MO
NPI 1649992504 · NPPES record last updated Sep 16, 2022
Key facts
- NPI
- 1649992504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2022033771 (MO)
- Practice address
- 14571 State Highway 72
Patton, MO 63662-7294 - Phone
- (573) 866-0060
- NPI assigned
- Sep 16, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022033771 | MO | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2022033771 | MO | Yes |
Addresses
Primary practice location
14571 State Highway 72
Patton, MO 63662-7294
Mailing address
14571 State Highway 72
Patton, MO 63662-7294
Phone (573) 866-0060
Other providers in Patton, MO
All providers in Patton, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.