Provider Demographics
NPI:1346533973
Name:TAGLIARINI, DARREN C (BCBA)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:C
Last Name:TAGLIARINI
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 SYLVAN DR
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-2157
Mailing Address - Country:US
Mailing Address - Phone:904-386-2841
Mailing Address - Fax:
Practice Address - Street 1:43 SYLVAN DR
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-2157
Practice Address - Country:US
Practice Address - Phone:904-386-2841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-11-8184103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst