Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician |
NPI | 1003345810 |
---|---|
Provider Name | Lajerrick D. Taylor |
First Address | Lecompte, LA 71346-0111 |
Second Address | Lecompte, LA 71346 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2017 |
Last Update Date | 17/05/2018 |