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General NPI Number Information
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NPI Number | 1790879450
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Entity Type | Individual
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Provider Name | LATRICIA D TAYLOR LPC-S, NCC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 14020 N WESTERN AVE # 101
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City | EDMOND
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State | OK
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Zip | 73013-1977
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Country | US
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Telephone | 405-509-5466
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 224
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City | JENKS
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State | OK
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Zip | 74037-0224
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Country | US
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Telephone | 405-509-5466
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3886
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3886
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License Number State | OK
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