Taylor Ann Gustafson

NPI #1578026951 in Grand Ronde, Oregon

Provider Information

NPI Number: 1578026951
Entity Type: Individual
Name: Taylor Ann Gustafson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 11, 2019
Last Updated: May 1, 2024

Practice Location

Address: 9605 GRAND RONDE RD
City: Grand Ronde
State: Oregon
ZIP Code: 97347-9712
Phone: (503) 879-2078

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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