Provider Demographics
NPI:1699490623
Name:TAKE ROOT ABA
Entity type:Organization
Organization Name:TAKE ROOT ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:TAYLIN
Authorized Official - Middle Name:RHEY
Authorized Official - Last Name:BYERLY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:813-766-2678
Mailing Address - Street 1:7206 RONNIE GARDENS CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-6990
Mailing Address - Country:US
Mailing Address - Phone:407-361-3295
Mailing Address - Fax:
Practice Address - Street 1:7206 RONNIE GARDENS CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-6990
Practice Address - Country:US
Practice Address - Phone:407-361-3295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty