Provider Demographics
NPI:1427626944
Name:SOTO, TAYLOR MAREE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MAREE
Last Name:SOTO
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 1:1026 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-1255
Mailing Address - Country:US
Mailing Address - Phone:440-320-3364
Mailing Address - Fax:
Practice Address - Street 1:20522 FALCONS LANDING CIR
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-7595
Practice Address - Country:US
Practice Address - Phone:703-404-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000736235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist