Provider Demographics
NPI:1932805454
Name:DEMASE, TAYLORE (BCBA)
Entity type:Individual
Prefix:
First Name:TAYLORE
Middle Name:
Last Name:DEMASE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:487 GOFFLE RD
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-3003
Mailing Address - Country:US
Mailing Address - Phone:201-675-5389
Mailing Address - Fax:
Practice Address - Street 1:400 TENAFLY RD
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-7000
Practice Address - Country:US
Practice Address - Phone:201-777-4557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty