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General NPI Number Information
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NPI Number | 1073423927
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Entity Type | Organization
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Legal Business Name | YOUR INCLUSIVE BEHAVIORAL ASSESSMENT GROUP, LLC
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 4334 DORSET DR
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City | DAYTON
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State | OH
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Zip | 45405-1943
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Country | US
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Telephone | 937-476-1933
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Fax |
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Provider Business Mailing Address
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Address Line | 4334 DORSET DR
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City | DAYTON
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State | OH
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Zip | 45405-1943
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOTHERAPIST
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Name | KATERA JACKSON TAYLOR
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Credential | LPCC
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Telephone | 937-476-1933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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