Individual
DERRICK TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5323 N 118TH CT, MILWAUKEE, WI 53225-3085
(414) 296-5426
Mailing address
5850 GRANITE PKWY STE 600, PLANO, TX 75024-6753
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
T4601610329901
WI
Other
Enumeration date
09/02/2022
Last updated
09/02/2022
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