Provider Demographics
NPI:1710443726
Name:BAIN, TAYLOR ANN (MS, MED, BCBA, LBA)
Entity Type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:ANN
Last Name:BAIN
Suffix:
Gender:F
Credentials:MS, MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 MEDICAL CENTER DR STE F
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1771
Mailing Address - Country:US
Mailing Address - Phone:469-731-0957
Mailing Address - Fax:
Practice Address - Street 1:4601 MEDICAL CENTER DR STE F
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1771
Practice Address - Country:US
Practice Address - Phone:469-731-0957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1796103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst