Most Relevant Information
Provider Data
| NPI Number: | 1003418633 |
| Provider Name: | TAYLOR BRADSHAW |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/09/2020 |
| Last Updated: | 11/09/2020 |
Provider Practice Location
3875 TIGER PAW ST S
MEMPHIS
TN
381523920
Practice Location Phone/Fax
| Phone: | 9016785134 |
| Fax: |
Provider Mailing Location
10173 GREEN MOSS CV
CORDOVA
TN
380180115
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |