Individual
TAYLOR GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
U
Contact information
Practice address
3297 ARMAR DR, MARION, IA 52302-4748
(574) 387-4313
(574) 204-2868
Mailing address
215 RED COACH DR, MISHAWAKA, IN 46545-8307
(574) 387-4313
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12473826
IA
Other
Enumeration date
09/06/2024
Last updated
09/06/2024
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