Provider Demographics
NPI:1144914797
Name:TAYLOR, TABATHA (MS SLP)
Entity type:Individual
Prefix:
First Name:TABATHA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 OLD DEPOT RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:AR
Mailing Address - Zip Code:72730-2932
Mailing Address - Country:US
Mailing Address - Phone:479-206-8206
Mailing Address - Fax:833-873-4695
Practice Address - Street 1:49 OLD DEPOT RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:AR
Practice Address - Zip Code:72730-2932
Practice Address - Country:US
Practice Address - Phone:479-206-8206
Practice Address - Fax:479-206-8206
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202229235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist