Provider Demographics
NPI:1437747243
Name:HOFTIEZER, TAYLOR (MA BCBA)
Entity type:Individual
Prefix:MISS
First Name:TAYLOR
Middle Name:
Last Name:HOFTIEZER
Suffix:
Gender:F
Credentials:MA BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 PROFESSIONAL COURT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905
Mailing Address - Country:US
Mailing Address - Phone:765-404-3950
Mailing Address - Fax:765-360-1131
Practice Address - Street 1:80 PROFESSIONAL COURT
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905
Practice Address - Country:US
Practice Address - Phone:765-404-3950
Practice Address - Fax:765-360-1131
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-23-68180103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst