Individual
TAKAYA HALL BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3 GIDDING CT, IRMO, SC 29063-8363
(803) 497-4361
Mailing address
3 GIDDING CT, IRMO, SC 29063-8363
(803) 497-4361
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
LBA1236
MD
103K00000X
Behavior Analyst
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
12/26/2013
Last updated
01/09/2025
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