Most Relevant Information
Provider Data
| NPI Number: | 1003513532 |
| Provider Name: | TAYLOR A LUCAS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/15/2023 |
| Last Updated: | 02/20/2023 |
Provider Practice Location
12500 BRANTLEY COMMONS CT STE 101
FORT MYERS
FL
339075696
Practice Location Phone/Fax
| Phone: | 2392705921 |
| Fax: |
Provider Mailing Location
11200 CALLAWAY GREENS DR
FORT MYERS
FL
339138139
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |