Healthcare Provider Details

I. General information

NPI: 1134587199
Provider Name (Legal Business Name): MS. BRIENNA TAYLOR OCHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4024 W 74TH ST
PRAIRIE VILLAGE KS
66208-2943
US

IV. Provider business mailing address

4024 W 74TH ST
PRAIRIE VILLAGE KS
66208-2943
US

V. Phone/Fax

Practice location:
  • Phone: 913-372-2361
  • Fax: 772-675-9100
Mailing address:
  • Phone: 913-372-2361
  • Fax: 772-675-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-44712
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: