Provider Demographics
NPI:1043880230
Name:SIMON, TAYLOR RAE (MS, CFY-SLP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:RAE
Last Name:SIMON
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MASON VIEW LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-5199
Mailing Address - Country:US
Mailing Address - Phone:828-702-2971
Mailing Address - Fax:
Practice Address - Street 1:510 FLEMING ST STE A
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4250
Practice Address - Country:US
Practice Address - Phone:828-944-4515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2203286235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist