Individual
LEVI JACK TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 W. COMMERCE, YUKON, OK 73099
(405) 354-1928
(405) 354-1296
Mailing address
1300 S. COUNTRY CLUB RD., EL RENO, OK 73036
(405) 354-1928
(405) 354-1296
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/21/2011
Last updated
09/21/2011
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