NPI
Taylor Marie Van Dera
NPI 1487480356
Read from the NPPES registry on October 25, 2026.
Facts
- Status
- Active
- Credential
- M.A, BCBA
- Type
- Individual
- Enumeration date
- 2024-09-09
- Last updated
- 2024-09-09
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Specialties
Licenses
- License WI
- 1-24-75327
Location
- Practice location
- 569 Carter Ct
- City
- Kimberly WI
- Postal code
- 54136-2201
- Phone
- (920) 739-3009
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Behavior Analyst providers in Kimberly, WI. 6 with this primary taxonomy in the public file.
Other NPIs in Kimberly, WI. 100 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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