Provider Demographics
NPI:1689320954
Name:TAVERAS, YANKARLOS (BCBA)
Entity Type:Individual
Prefix:MR
First Name:YANKARLOS
Middle Name:
Last Name:TAVERAS
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 1:1400 MCCALLIE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-2927
Mailing Address - Country:US
Mailing Address - Phone:423-531-6961
Mailing Address - Fax:423-521-8094
Practice Address - Street 1:1400 MCCALLIE AVE STE 100
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2927
Practice Address - Country:US
Practice Address - Phone:423-531-6961
Practice Address - Fax:423-521-8094
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst