MEDICARE: TARA L. BATCHELOR BCABA

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	103K00000X	Behavior Analyst	0-03-0830	FL

General Provider Information

NPI Number	:	1902103278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA L. BATCHELOR BCABA

Provider Business Mailing Address
First Line	:	PO BOX 122
Second Line	:
City	:	DURANT
State	:	FL
Zip	:	33530-0122
Country	:	US
Telephone Number	:	813-784-4534
Fax Number	:	813-650-0102

Provider Business Practice Location Address
First Line	:	7825 TURKEY CREEK RD
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33567-3027
Country	:	US
Telephone Number	:	813-784-4534
Fax Number	:	813-650-0102

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

Provider Enumeration Date	:	02/22/2011
Last Update Date	:	02/22/2011

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