Healthcare Provider Details

I. General information

NPI: 1235756271
Provider Name (Legal Business Name): TARYN MARISA BEARDEN M.ED., BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 CORONADO CENTER DRIVE SUITE 200
HENDERSON NV
89052-3977
US

IV. Provider business mailing address

871 CORONADO CENTER DRIVE SUITE 200
HENDERSON NV
89052-3977
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax: 772-675-9100
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA0913
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: