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NPI Code Detail

MEDICARE: JASON TAYLOR

MEDICARE: JASON TAYLOR
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 : 1174011498
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON TAYLOR
Provider Business Mailing Address
First Line : 21 CHARNOCK HILL RD
Second Line :
City : RUTLAND
State : MA
Zip : 01543-1111
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 191 BARRE PAXTON RD
Second Line :
City : RUTLAND
State : MA
Zip : 01543-1239
Country : US
Telephone Number : 508-321-3060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2018
Last Update Date : 04/23/2018

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Directions to “ JASON TAYLOR ” Practice Location

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