MEDICARE: TAIJA COCHRAN

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1083561948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAIJA COCHRAN

Provider Business Mailing Address
First Line	:	3516 YACHT CLUB CT
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-1848
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 PARK PLACE BLVD STE C1
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-2358
Country	:	US
Telephone Number	:	407-385-0728
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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Directions to “ TAIJA COCHRAN ” Practice Location

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