Healthcare Provider Details

I. General information

NPI: 1629908231
Provider Name (Legal Business Name): TAYLOR JOLIE BOCHNOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8007 NW 122ND ST
OKLAHOMA CITY OK
73142-3302
US

IV. Provider business mailing address

1 NE 2ND ST APT 308
OKLAHOMA CITY OK
73104-2236
US

V. Phone/Fax

Practice location:
  • Phone: 405-603-6622
  • Fax:
Mailing address:
  • Phone: 915-996-0187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCF889
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: