Individual
MS. MARIANNE TAYLOR IDOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
209 E RIDGE CT, JACKSONVILLE, NC 28540-7622
(910) 709-2170
(910) 333-1799
Mailing address
209 E RIDGE CT, JACKSONVILLE, NC 28540-7622
(910) 709-2170
(910) 333-1799
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-09-5879
NC
Other
Enumeration date
12/17/2009
Last updated
12/17/2009
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