Individual
MS. AVIS M TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
2530 S COMMERCE, ARDMORE, OK 73401
(580) 223-5636
Mailing address
415 WILLOWRIDGE ST APT I7, ARDMORE, OK 73401-2258
(580) 223-5636
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2437
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101Y00000X
—
OK
Enumeration date
06/27/2007
Last updated
07/09/2007
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