Provider Demographics
NPI:1154161834
Name:POLITTE, TAYLOR HOPE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:HOPE
Last Name:POLITTE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MRS
Other - First Name:TAYLOR
Other - Middle Name:HOPE
Other - Last Name:MCGRAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:280 CHARLES BASS RD
Mailing Address - Street 2:
Mailing Address - City:BEEBE
Mailing Address - State:AR
Mailing Address - Zip Code:72012-9618
Mailing Address - Country:US
Mailing Address - Phone:501-288-1998
Mailing Address - Fax:
Practice Address - Street 1:1201 N ALTON ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IL
Practice Address - Zip Code:62254-1103
Practice Address - Country:US
Practice Address - Phone:501-288-1998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202107235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist