Individual
TRAVONTAY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 CALEDONIA ST, LA CROSSE, WI 54603-2616
(608) 785-4100
Mailing address
4445 MORMON COULEE RD, LA CROSSE, WI 54601-8259
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/14/2024
Last updated
02/14/2024
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