Individual
TAYLOR PHOENIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5095 S 1481 RD, STOCKTON, MO 65785-9715
(385) 770-6026
Mailing address
5095 S 1481 RD, STOCKTON, MO 65785-9715
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-499324
MO
106S00000X
Behavior Technician
Primary
—
UT
Other
Enumeration date
12/15/2025
Last updated
06/02/2026
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