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Individual

GARY TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
9587 E CACTUS RANCH RD, HEREFORD, AZ 85615-8005
(520) 366-5262
Mailing address
9587 E CACTUS RANCH RD, HEREFORD, AZ 85615-8005
(520) 366-5262

Taxonomy

Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000000000
AZ
Enumeration date
11/17/2008
Last updated
07/21/2022
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