Individual
AMANDA JANE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
217 N WATER AVE, TAHLEQUAH, OK 74464-2825
(888) 692-6590
Mailing address
1808 N 14TH ST, BROKEN ARROW, OK 74012-9349
(574) 849-8737
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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