| NPI | 1720576622 |
|---|---|
| Other Name | ROSE CHARLENE TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: FL 11-1268-GH) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2019-06-20 |