Individual
RANDALL TAYLOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7185 BUCK CREEK DR, FAIRBURN, GA 30213-3113
(704) 300-2788
Mailing address
7185 BUCK CREEK DR, FAIRBURN, GA 30213-3113
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
106S00000X
GA
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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