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NPI Code Detail

MEDICARE: REBECCA LYNN TAYLOR RBT-17-37108

MEDICARE: REBECCA LYNN TAYLOR RBT-17-37108
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-17-37108AZ

General Provider Information

NPI Number : 1083266738
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA LYNN TAYLOR RBT-17-37108
Provider Business Mailing Address
First Line : 948 S ALMA SCHOOL RD UNIT 97
Second Line :
City : MESA
State : AZ
Zip : 85210-2056
Country : US
Telephone Number : 480-234-6957
Fax Number : 480-685-9879
Provider Business Practice Location Address
First Line : 2045 S VINEYARD STE 223
Second Line :
City : MESA
State : AZ
Zip : 85210-6826
Country : US
Telephone Number : 480-656-3530
Fax Number : 480-685-9879
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2019
Last Update Date : 07/12/2019

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Directions to “ REBECCA LYNN TAYLOR RBT-17-37108” Practice Location

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