Provider Demographics
NPI:1407370505
Name:DILLMAN, TAYLOR ASHLEIGH
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ASHLEIGH
Last Name:DILLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 DAYTON XENIA RD STE 900
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-6391
Mailing Address - Country:US
Mailing Address - Phone:801-900-3941
Mailing Address - Fax:
Practice Address - Street 1:3195 DAYTON XENIA RD STE 900
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-6391
Practice Address - Country:US
Practice Address - Phone:801-900-3941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12247056-35011041C0700X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical