Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-48031 | TN |
N | 106S00000X | Behavior Technician | RBT-20-145741 | TN |
N | 156F00000X | Technician/Technologist |
NPI | 1104382241 |
---|---|
Provider Name | Taylor Oliver |
First Address | Knoxville, TN 37934-2890 |
Second Address | Knoxville, TN 37923-4729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2019 |
Last Update Date | 19/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1-21-48031 | BACB (01) | TN |
RBT-20-145741 | BACB (01) | TN |