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NPI Code Detail

MEDICARE: MRS. CORY TAYLOR NEUSCHE MA, PLPC

MEDICARE: MRS. CORY TAYLOR NEUSCHE MA, PLPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMO

General Provider Information

NPI Number : 1588932602
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CORY TAYLOR NEUSCHE MA, PLPC
Provider Business Mailing Address
First Line : 130 CALO LN
Second Line :
City : LAKE OZARK
State : MO
Zip : 65049-9208
Country : US
Telephone Number : 866-153-1375
Fax Number :
Provider Business Practice Location Address
First Line : 130 CALO LN
Second Line :
City : LAKE OZARK
State : MO
Zip : 65049-9208
Country : US
Telephone Number : 866-153-1375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2011
Last Update Date : 07/06/2012

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