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General NPI Number Information
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NPI Number | 1023600343
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Entity Type | Individual
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Provider Name | SAMANTHA TAYLOR BCBA
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Gender | Female
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 01/12/2025
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Provider Practice Location Address
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Address Line | 4201 BRIDLEPATH CT
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-8813
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Country | US
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Telephone | 540-847-1936
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Fax |
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Provider Business Mailing Address
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Address Line | 13411 FARMER DR
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City | WOODFORD
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State | VA
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Zip | 22580-2815
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Country | US
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Telephone | 540-654-6229
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0133004053
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License Number State | VA
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