Provider Demographics
NPI:1629372453
Name:TAYLOR, MARGARET KATHRYN (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:KATHRYN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4006 SHEFFLERA DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-4519
Mailing Address - Country:US
Mailing Address - Phone:325-450-5042
Mailing Address - Fax:
Practice Address - Street 1:4006 SHEFFLERA DR
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-4519
Practice Address - Country:US
Practice Address - Phone:325-450-5042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-09
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-11-8961103K00000X
TX1908103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst