Individual
JAYDEN TANIELU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2144 SUMTER ST, COLUMBIA, SC 29201-2182
(803) 497-4303
Mailing address
2144 SUMTER ST, COLUMBIA, SC 29201-2182
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
SC
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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