Provider Demographics
NPI:1972872489
Name:TAYLOR, COLLEEN (BCBA)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:C
Other - Last Name:FITZPATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 INTERNATIONAL PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5028
Mailing Address - Country:US
Mailing Address - Phone:407-915-7729
Mailing Address - Fax:407-588-6294
Practice Address - Street 1:2868 MAHAN DR UNIT 25, 26, 27
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-391-6060
Practice Address - Fax:850-692-6206
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-42008103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst