Individual
TAYLEN MAE ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 N 3RD ST STE I, LARAMIE, WY 82072-2543
(307) 212-3284
Mailing address
PO BOX 20310, PMB 55984, CHEYENNE, WY 82003-7007
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/18/2022
Last updated
10/28/2022
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