Provider Demographics
NPI:1588932602
Name:NEUSCHE, CORY TAYLOR (MA, PLPC)
Entity type:Individual
Prefix:MRS
First Name:CORY
Middle Name:TAYLOR
Last Name:NEUSCHE
Suffix:
Gender:F
Credentials:MA, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CALO LN
Mailing Address - Street 2:
Mailing Address - City:LAKE OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65049-9208
Mailing Address - Country:US
Mailing Address - Phone:866-153-1375
Mailing Address - Fax:
Practice Address - Street 1:130 CALO LN
Practice Address - Street 2:
Practice Address - City:LAKE OZARK
Practice Address - State:MO
Practice Address - Zip Code:65049-9208
Practice Address - Country:US
Practice Address - Phone:866-153-1375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-03
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health