Provider Demographics
NPI:1598218711
Name:VILE, TAYLOR (MOT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:VILE
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:HULMEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-5829
Mailing Address - Country:US
Mailing Address - Phone:215-409-8184
Mailing Address - Fax:
Practice Address - Street 1:105 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:HULMEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19047-5829
Practice Address - Country:US
Practice Address - Phone:215-409-8184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATOC103261225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist