Provider Demographics
NPI:1811158991
Name:TAYLOR, LOREN DAY (OT)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:DAY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1108
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36633-1108
Mailing Address - Country:US
Mailing Address - Phone:251-431-5818
Mailing Address - Fax:251-431-5810
Practice Address - Street 1:305 NORTH WATER ST.
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36602
Practice Address - Country:US
Practice Address - Phone:251-431-5818
Practice Address - Fax:251-431-5810
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2922174400000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051101977OtherBCBS NEW AIRPORT ADDRESS
AL2922OtherOCCUPATIONAL THERAPY LICENSE
AL510I670024OtherMEDICARE
ALL223OtherMEDICARE GRP