Provider Demographics
NPI:1609529593
Name:COREY, TAYLAR (BCBA)
Entity type:Individual
Prefix:
First Name:TAYLAR
Middle Name:
Last Name:COREY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4860 WESTCHESTER DR APT 5
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2578
Mailing Address - Country:US
Mailing Address - Phone:330-507-5066
Mailing Address - Fax:
Practice Address - Street 1:2349 SHAWNEE TRL
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44511-1371
Practice Address - Country:US
Practice Address - Phone:330-507-3893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst