Provider Demographics
NPI:1861964041
Name:STEPHENSON, TAYLOR ANNE (BCBA)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANNE
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:TAYLOR
Other - Middle Name:ANNE
Other - Last Name:STEPHENSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:10301 RANCH ROAD 2222 APT 1923
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-1260
Mailing Address - Country:US
Mailing Address - Phone:713-452-9180
Mailing Address - Fax:
Practice Address - Street 1:2301 BAGDAD RD STE 305
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-6503
Practice Address - Country:US
Practice Address - Phone:512-900-8110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3463103K00000X
TX2384106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst