Individual
TAYLOR MARIE TYNEWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
283 BUTLER RD, MOUNT GRETNA, PA 17064-6085
(717) 279-2774
Mailing address
PO BOX 550, MOUNT GRETNA, PA 17064-0550
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH005098
PA
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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