1316681141 NPI number — MISS ALEXIS MORGAN TAYLOR

Table of content: MISS ALEXIS MORGAN TAYLOR (NPI 1316681141)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316681141 NPI number — MISS ALEXIS MORGAN TAYLOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAYLOR
Provider First Name:
ALEXIS
Provider Middle Name:
MORGAN
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316681141
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
611 WALNUT STREET, PO BOX 244
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARTINS FERRY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43935
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-609-5072
Provider Business Mailing Address Fax Number:
740-609-5073

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
611 WALNUT STREET,
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARTINS FERRY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-609-5072
Provider Business Practice Location Address Fax Number:
740-609-5073
Provider Enumeration Date:
04/27/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: BACB1-21-53083 . This is a "BOARD CERTIFIED BEHAVIOR ANALYST" identifier . This identifiers is of the category "OTHER".




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