Provider Demographics
NPI:1467148064
Name:TAYLOR, DANA ELIZABETH
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:ELIZABETH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9618 SHIRLEY COUCH WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-4285
Mailing Address - Country:US
Mailing Address - Phone:865-310-6409
Mailing Address - Fax:
Practice Address - Street 1:9618 SHIRLEY COUCH WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-4285
Practice Address - Country:US
Practice Address - Phone:865-310-6409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-22-230019106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician