Individual
MADISON MAVIS MERTHA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1707 VILLAGE CENTER CIR STE 140, LAS VEGAS, NV 89134-0577
(702) 766-9840
Mailing address
1707 VILLAGE CENTER CIR STE 140, LAS VEGAS, NV 89134-0577
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-428289
NV
Other
Enumeration date
06/17/2025
Last updated
06/17/2025
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