Individual provider · Type 1 NPI
Taylor Siracusa
Developmental Therapist · Poplar Grove, IL
Practice location
309 W Edson St
Poplar Grove, IL 61065-8556
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Therapist Primary | 222Q00000X | None listed |
Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…
About NPI 1336001940
Taylor Siracusa's National Provider Identifier is 1336001940, issued on Dec 2, 2025. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Poplar Grove, IL. The record was last updated on Dec 2, 2025.