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Individual

ASHLEE TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
804 S BROADWAY ST, POTEAU, OK 74953-3834
(918) 647-9629
Mailing address
804 S BROADWAY ST, POTEAU, OK 74953-3834
(918) 647-9629

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
06962
OK
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000000
OK
05
200692320A
OK
Enumeration date
02/28/2017
Last updated
08/13/2025
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