Provider Demographics
NPI:1619569779
Name:TAYLOR, ANNA CATE (BCBA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CATE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:ELIZABETH
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11865 WEXFORD CLUB DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-1471
Mailing Address - Country:US
Mailing Address - Phone:925-752-2119
Mailing Address - Fax:404-481-2699
Practice Address - Street 1:11865 WEXFORD CLUB DR
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-1471
Practice Address - Country:US
Practice Address - Phone:925-752-2119
Practice Address - Fax:404-481-2699
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
GA1-23-63684103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician