MEDICARE: MILTON TAYLOR, PH.D., M.A.

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
1	102L00000X	Psychoanalyst
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1942694690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILTON TAYLOR, PH.D., M.A.

Provider Business Mailing Address
First Line	:	2510 E SUNSET RD
Second Line	:	SUITE 5-159
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3522
Country	:	US
Telephone Number	:	702-335-8454
Fax Number	:

Provider Business Practice Location Address
First Line	:	2510 E SUNSET RD
Second Line	:	SUITE 5-159
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3522
Country	:	US
Telephone Number	:	702-335-8454
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & OWNER
Name	:	DR. MILTON TAYLOR
Credential	:	PH.D., M.A.
Telephone Number	:	702-335-8454

Provider Enumeration Date	:	03/20/2015
Last Update Date	:	03/20/2015

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