Provider Demographics
NPI:1043839103
Name:GRAY, TAYLOR MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MARIE
Last Name:GRAY
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 1:3243 HERITAGE CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3553
Mailing Address - Country:US
Mailing Address - Phone:828-713-0560
Mailing Address - Fax:865-951-7273
Practice Address - Street 1:3243 HERITAGE CIR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3553
Practice Address - Country:US
Practice Address - Phone:828-713-0560
Practice Address - Fax:865-951-7273
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13066225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist