Provider Demographics
NPI:1194571273
Name:TAGGART, COURTNEY (BSW)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:TAGGART
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3537 W 112TH ST S
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-2493
Mailing Address - Country:US
Mailing Address - Phone:817-239-5592
Mailing Address - Fax:
Practice Address - Street 1:7477 E 46TH PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-6305
Practice Address - Country:US
Practice Address - Phone:918-384-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator