Provider Demographics
NPI:1114766185
Name:MAGGARD, TAYLOR PAIGE (MA, CF-SLP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:PAIGE
Last Name:MAGGARD
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1305
Mailing Address - Country:US
Mailing Address - Phone:606-493-7009
Mailing Address - Fax:
Practice Address - Street 1:400 FARRIS PARKS BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-7650
Practice Address - Country:US
Practice Address - Phone:859-353-3666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY292366235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist