Provider Demographics
NPI:1154619690
Name:TAYLOR, BAILEE A (BHRS)
Entity type:Individual
Prefix:
First Name:BAILEE
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73018-3301
Mailing Address - Country:US
Mailing Address - Phone:405-222-4786
Mailing Address - Fax:405-222-1615
Practice Address - Street 1:117 S 7TH ST
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-3301
Practice Address - Country:US
Practice Address - Phone:405-222-4786
Practice Address - Fax:405-222-1615
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor