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NPI Code Detail

MEDICARE: MRS. MELISSA DAWN MCCULLEY TAYLOR

MEDICARE: MRS. MELISSA DAWN MCCULLEY TAYLOR
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 Counselor

General Provider Information

NPI Number : 1346528197
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELISSA DAWN MCCULLEY TAYLOR
Provider Business Mailing Address
First Line : 500 N NEVADA ST
Second Line :
City : WEATHERFORD
State : OK
Zip : 73096-5729
Country : US
Telephone Number : 580-302-1900
Fax Number :
Provider Business Practice Location Address
First Line : 100 N 31ST ST
Second Line :
City : CLINTON
State : OK
Zip : 73601-9118
Country : US
Telephone Number : 580-323-6021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2011
Last Update Date : 07/27/2011

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