Healthcare Provider Details

I. General information

NPI: 1356815161
Provider Name (Legal Business Name): TAYLOR RENEE TRIMPE MABA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAYLOR LUHR

II. Dates (important events)

Enumeration Date: 01/15/2019
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5522 TAYLOR MILL RD
TAYLOR MILL KY
41015-4604
US

IV. Provider business mailing address

8154 MILL CREEK CIR
WEST CHESTER OH
45069-1651
US

V. Phone/Fax

Practice location:
  • Phone: 855-444-5664
  • Fax:
Mailing address:
  • Phone: 224-637-0028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-61001
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: