Provider Demographics
NPI:1780221382
Name:TAYLOR, PIERCE II (BCABA)
Entity Type:Individual
Prefix:MR
First Name:PIERCE
Middle Name:
Last Name:TAYLOR
Suffix:II
Gender:M
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5116 TARA CREEK CT
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-8005
Mailing Address - Country:US
Mailing Address - Phone:850-910-1522
Mailing Address - Fax:
Practice Address - Street 1:791 RINEHART RD
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4876
Practice Address - Country:US
Practice Address - Phone:407-413-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-19-104933106S00000X
0-21-12476106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician