Most Relevant Information
Provider Data
| NPI Number: | 1003559006 |
| Provider Name: | TAYLEN MAE ROBERTSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/18/2022 |
| Last Updated: | 10/28/2022 |
Provider Practice Location
1050 N 3RD ST STE I
LARAMIE
WY
820722543
Practice Location Phone/Fax
| Phone: | 3072123284 |
| Fax: |
Provider Mailing Location
PO BOX 20310
PMB 55984
CHEYENNE
WY
820037007
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |