Provider Information for 1114706074
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TAYLOR KLUMP
Sex: Female
NPI: 1114706074
Last Updated: 2023-09-28
Certification Date: 2023-09-20
Certification Date: 2023-09-20
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1114706074 | ||||||||
| Enumeration Date | 2023-09-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2021 GUADALUPE ST STE 260 AUSTIN, TX 78705-5654 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 2021 GUADALUPE ST STE 260 AUSTIN, TX 78705-5654 United States Phone: 646-453-6777 | Fax: | ||||||||
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