Individual
TAYLOR FAIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
5840 N CANTON CENTER RD STE 270, CANTON, MI 48187-2614
(734) 366-1665
Mailing address
5840 N CANTON CENTER RD STE 270, CANTON, MI 48187-2614
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
08/15/2023
Last updated
10/28/2024
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