Ansley Nicole Taylor, M.ED.

Individual provider Active NPI Speech-Language Pathologist · Lavonia, GA

NPI 1669216487 · NPPES record last updated Jun 25, 2024

Key facts

NPI
1669216487
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
PCET004009 (GA)
Practice address
367 Clear Creek Pkwy
Lavonia, GA 30553-4173
Phone
(706) 356-7450
Fax
(706) 356-7451
NPI assigned
Jun 25, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
PCET004009GAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X PCET004009 GA Yes

Addresses

Primary practice location

367 Clear Creek Pkwy
Lavonia, GA 30553-4173

Mailing address

480 E Broad St Apt 203
Athens, GA 30601-2817
Phone (770) 331-0241

Other providers in Lavonia, GA

All providers in Lavonia, GA · Speech-Language Pathologist in Georgia

Sources for this page

Verify at the official NPI Registry.