Provider Demographics
NPI:1417747825
Name:TAYLOR, TIERRA KATHLEEN I (BT)
Entity type:Individual
Prefix:MISS
First Name:TIERRA
Middle Name:KATHLEEN
Last Name:TAYLOR
Suffix:I
Gender:
Credentials:BT
Other - Prefix:MISS
Other - First Name:TIERRA
Other - Middle Name:KATHLEEN
Other - Last Name:TAYLOR
Other - Suffix:I
Other - Last Name Type:Other Name
Other - Credentials:BT
Mailing Address - Street 1:5850 GRANITE PKWY STE 600
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-6753
Mailing Address - Country:US
Mailing Address - Phone:818-345-2345
Mailing Address - Fax:
Practice Address - Street 1:33315 S 23RD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4409
Practice Address - Country:US
Practice Address - Phone:253-345-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician