Individual
MARK L TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS LPC NCC NCPC
Contact information
Practice address
308 EAST DOWNING STREET, TAHLEQUAH, OK 74464-4603
(918) 506-4012
(918) 506-4013
Mailing address
308 E DOWNING ST, TAHLEQUAH, OK 74464-3014
(918) 506-4012
(918) 506-4013
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3556
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100734620H
—
OK
05
—
200053340B
—
OK
Enumeration date
03/26/2007
Last updated
01/16/2013
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