Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1144694928 |
---|---|
Provider Name | Kelly Taylor |
First Address | Nashville, TN 37217-2679 |
Second Address | North Charleston, SC 29405-4764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2015 |
Last Update Date | 19/11/2020 |