Healthcare Provider Details

I. General information

NPI: 1073423927
Provider Name (Legal Business Name): YOUR INCLUSIVE BEHAVIORAL ASSESSMENT GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4334 DORSET DR
DAYTON OH
45405-1943
US

IV. Provider business mailing address

4334 DORSET DR
DAYTON OH
45405-1943
US

V. Phone/Fax

Practice location:
  • Phone: 937-476-1933
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KATERA JACKSON TAYLOR
Title or Position: LICENSED PSYCHOTHERAPIST
Credential: LPCC
Phone: 937-476-1933