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1164002044
BRANDON TAYLOR
WAUWATOSA, WI
NPI
1164002044
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 19183-130)
Enumeration Date
2021-04-13
Last Update Date
2021-04-13
Business Address
Mr. BRANDON TAYLOR
10721 W CAPITOL DR STE 210
WAUWATOSA, WI 53222-1210
Phone number: 414-988-3079
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Mailing Address
Mr. BRANDON TAYLOR
10721 W CAPITOL DR STE 210
WAUWATOSA, WI 53222-1210
Phone number: 414-988-3079
Copy
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