Derrick Taylor
Behavior Technician in Milwaukee, WI. Individual provider (NPI-1).
NPI number1609596188
StatusActive
Last updated in NPPESSep 2, 2022
Details
- NPI
- 1609596188
- Entity type
- Individual (NPI-1)
- Name
- Derrick Taylor
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 2, 2022
- Certification date
- Sep 2, 2022
- Last updated
- Sep 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | T4601610329901 | WI | Yes |
Practice location
5323 N 118th CtMilwaukee, WI 53225-3085
Phone 414-296-5426
Mailing address
5850 Granite Pkwy Ste 600Plano, TX 75024-6753
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