Individual
TAYLOR RENEE COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, BCBA
Contact information
Practice address
251 W 84TH DR, MERRILLVILLE, IN 46410-6243
(219) 205-3463
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-55759
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-55759
BACB CERTIFICATE
—
Enumeration date
03/29/2019
Last updated
11/30/2021
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