Individual
MADISON TAYLOR WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7475 SW OLESON RD, PORTLAND, OR 97223-7474
(971) 804-0907
Mailing address
15750 SW OREGON ST APT 203, SHERWOOD, OR 97140-9622
(949) 310-5060
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
B-10244325
OR
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/03/2021
Last updated
06/11/2024
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