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General NPI Number Information
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NPI Number | 1164011755
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Entity Type | Individual
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Provider Name | KALEIGH TAGUE
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Gender | Female
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Dates
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Enumeration Date | 01/18/2021
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 6300 BEE CAVES RD BLDG 2
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City | AUSTIN
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State | TX
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Zip | 78746-5833
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Country | US
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Telephone | 512-572-0157
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Fax |
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Provider Business Mailing Address
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Address Line | 8239 CAPE DR N
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-4356
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Country | US
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Telephone | 765-918-1598
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-65161
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License Number State | IN
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