Provider Demographics
NPI:1902129984
Name:TAYLOR, YOLANDA (OTR/L)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5233 WINERY DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-1620
Mailing Address - Country:US
Mailing Address - Phone:336-413-7815
Mailing Address - Fax:
Practice Address - Street 1:5345 MARIAN LN
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1841
Practice Address - Country:US
Practice Address - Phone:757-456-5018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-05
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112861225X00000X
NC7029225X00000X
VA0119004358225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist