Provider Demographics
NPI:1093145799
Name:TAYLOR, SARA LYNN (MS ED, BCBA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS ED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5127 WEBB ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2525
Mailing Address - Country:US
Mailing Address - Phone:508-266-1836
Mailing Address - Fax:
Practice Address - Street 1:5127 WEBB ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2525
Practice Address - Country:US
Practice Address - Phone:508-266-1836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-15
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-13-13592103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst