Individual
TAYLOR MICHELLE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, BCBA, LBA
Contact information
Practice address
117 E JEFFERSON ST, GEORGETOWN, KY 40324-1764
(859) 224-2273
(859) 224-4675
Mailing address
109 WIND HAVEN DR STE 100, NICHOLASVILLE, KY 40356-8010
(859) 224-2273
(859) 224-4675
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-20-45592
CA
103K00000X
Behavior Analyst
Primary
271557
KY
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-20-45592
BCBA CERTIFICATE
—
Enumeration date
10/22/2017
Last updated
11/20/2023
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