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NPI Code Detail

MEDICARE: TAYLOR LINDSEY CRAWFORD RBT

MEDICARE:   TAYLOR LINDSEY CRAWFORD  RBT
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 Technician

General Provider Information

NPI Number : 1861991192
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR LINDSEY CRAWFORD RBT
Provider Business Mailing Address
First Line : 15030 ORANGE RIVER RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33905-7661
Country : US
Telephone Number : 239-272-3189
Fax Number :
Provider Business Practice Location Address
First Line : 5432 RATTLESNAKE HAMMOCK RD
Second Line :
City : NAPLES
State : FL
Zip : 34113-7454
Country : US
Telephone Number : 239-316-7656
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2018
Last Update Date : 02/01/2018

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