Provider Demographics
NPI:1215405857
Name:TAYLOR, CHRIS D SR
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:D
Last Name:TAYLOR
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2113 W BRITTON RD
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGE
Mailing Address - State:OK
Mailing Address - Zip Code:73120-1505
Mailing Address - Country:US
Mailing Address - Phone:405-840-9000
Mailing Address - Fax:
Practice Address - Street 1:2113 W BRITTON RD
Practice Address - Street 2:
Practice Address - City:THE VILLAGE
Practice Address - State:OK
Practice Address - Zip Code:73120-1505
Practice Address - Country:US
Practice Address - Phone:405-840-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)