Provider Demographics
NPI:1588397244
Name:WHITE, TAYLOR (OTD)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1219 FREEDOM DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-8081
Mailing Address - Country:US
Mailing Address - Phone:865-809-5808
Mailing Address - Fax:
Practice Address - Street 1:204 HARNETT CT
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-2065
Practice Address - Country:US
Practice Address - Phone:931-538-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7332225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist