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NPI Code Detail

MEDICARE: TAYLOR MCINTYRE RBT

MEDICARE: TAYLOR MCINTYRE 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 : 1003483363
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR MCINTYRE RBT
Provider Business Mailing Address
First Line : 273 N THOMPSON DR APT 8
Second Line :
City : MADISON
State : WI
Zip : 53714-2092
Country : US
Telephone Number : 920-639-7343
Fax Number :
Provider Business Practice Location Address
First Line : 901 WHALEN RD
Second Line :
City : VERONA
State : WI
Zip : 53593-1765
Country : US
Telephone Number : 920-639-7343
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2021
Last Update Date : 06/07/2021

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Directions to “ TAYLOR MCINTYRE RBT” Practice Location

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