Healthcare Provider Details

I. General information

NPI: 1124941497
Provider Name (Legal Business Name): TAYLOR DABNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6140 W EXECUTIVE DR
MEQUON WI
53092-4499
US

IV. Provider business mailing address

5600 W GREEN TREE RD
MILWAUKEE WI
53223-5218
US

V. Phone/Fax

Practice location:
  • Phone: 414-491-8830
  • Fax:
Mailing address:
  • Phone: 414-491-8830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: