Provider Demographics
NPI:1972872489
Name:TAYLOR, COLLEEN F (BCBA)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:F
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:C
Other - Last Name:FITZPATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3629 MEADOW VISTA LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5792
Mailing Address - Country:US
Mailing Address - Phone:904-535-0876
Mailing Address - Fax:
Practice Address - Street 1:3629 MEADOW VISTA LN
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5792
Practice Address - Country:US
Practice Address - Phone:904-535-0876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-42008103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst