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NPI Code Detail

MEDICARE: MISS THERESA E TAYLOR BACB

MEDICARE: MISS THERESA E TAYLOR BACB
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor1062795MA
2103K00000XBehavior Analyst848MA

General Provider Information

NPI Number : 1013083641
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS THERESA E TAYLOR BACB
Provider Business Mailing Address
First Line : 21 CHARNOCK HILL RD
Second Line :
City : RUTLAND
State : MA
Zip : 01543-1111
Country : US
Telephone Number : 508-887-1652
Fax Number :
Provider Business Practice Location Address
First Line : 191 BARRE PAXTON RD
Second Line :
City : RUTLAND
State : MA
Zip : 01543-1239
Country : US
Telephone Number : 508-321-3060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2006
Last Update Date : 04/21/2018

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Directions to “ MISS THERESA E TAYLOR BACB” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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