Provider Demographics
NPI:1609374602
Name:MILLER, TAYLOR S
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:S
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:J
Other - Last Name:STRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:DANA BLAIR - PERFORMANCE THERAPY
Mailing Address - Street 2:PO BOX 890
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39130-0890
Mailing Address - Country:US
Mailing Address - Phone:601-278-7526
Mailing Address - Fax:601-898-3699
Practice Address - Street 1:322 HWY 80 EAST
Practice Address - Street 2:STE 3
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-4726
Practice Address - Country:US
Practice Address - Phone:601-460-0910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
S4322235Z00000X
MSS4322235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty