Provider Demographics
NPI:1184191926
Name:TAYLOR, BOBBIE JEAN (BHWC)
Entity Type:Individual
Prefix:
First Name:BOBBIE
Middle Name:JEAN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:BHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 WESTBURY DR
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-8209
Mailing Address - Country:US
Mailing Address - Phone:813-368-3208
Mailing Address - Fax:
Practice Address - Street 1:2044 WESTBURY DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-8209
Practice Address - Country:US
Practice Address - Phone:813-368-3208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health