Tayva Grace Carruthers

NPI #1003529272 in Hermantown, Minnesota

Provider Information

NPI Number: 1003529272
Entity Type: Individual
Name: Tayva Grace Carruthers
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jan 3, 2023
Last Updated: Jan 3, 2023

Practice Location

Address: 4140 RICHARD AVE STE 200
City: Hermantown
State: Minnesota
ZIP Code: 55811-3309
Phone: (218) 520-3411

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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