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NPI Code Detail

MEDICARE: TAYLOR LUKENS MS, BCBA, LBA

MEDICARE: TAYLOR LUKENS MS, BCBA, LBA
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
1103K00000XBehavior Analyst0133003078VA

General Provider Information

NPI Number : 1770129736
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR LUKENS MS, BCBA, LBA
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 923 GARDENS BLVD
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22901-1472
Country : US
Telephone Number : 434-201-3893
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2019
Last Update Date : 08/14/2023

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