Individual
TAYLOR PAIGE TADLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1018 N BRAGG BLVD, SPRING LAKE, NC 28390-3316
(910) 295-2609
Mailing address
1018 N BRAGG BLVD, SPRING LAKE, NC 28390-3316
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
RBT-19-77043
NC
Other
Enumeration date
02/01/2019
Last updated
02/01/2019
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