Provider Demographics
NPI:1114461076
Name:TAYLOR, CHEMISE (MAT, BCBA, LBA)
Entity Type:Individual
Prefix:MS
First Name:CHEMISE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MAT, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12741 DARBY BROOK CT STE 102
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2406
Mailing Address - Country:US
Mailing Address - Phone:888-467-8241
Mailing Address - Fax:888-241-6363
Practice Address - Street 1:12741 DARBY BROOK CT STE 102
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2406
Practice Address - Country:US
Practice Address - Phone:571-346-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA11622233103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst