Individual
TAYLOR ROSE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 N DELAWARE AVE, PHILADELPHIA, PA 19125-4305
(267) 807-0550
Mailing address
2716 S 18TH ST, PHILADELPHIA, PA 19145-4703
(215) 433-2958
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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