Healthcare Provider Details

I. General information

NPI: 1760012470
Provider Name (Legal Business Name): COURTNEY TAYLOR BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY NEWCOMER BCBA, LBA

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 BUCK MEADOW DR
RUSTON LA
71270-7445
US

IV. Provider business mailing address

153 BUCK MEADOW DR
RUSTON LA
71270-7445
US

V. Phone/Fax

Practice location:
  • Phone: 318-237-9823
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberL-423
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA2656
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: