Provider Demographics
NPI:1275950941
Name:TRAYLOR, CHRISTOPHER ANDRAE
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ANDRAE
Last Name:TRAYLOR
Suffix:
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 1:40119 STATE HIGHWAY 59
Mailing Address - Street 2:
Mailing Address - City:BYARS
Mailing Address - State:OK
Mailing Address - Zip Code:74831-7931
Mailing Address - Country:US
Mailing Address - Phone:405-361-5055
Mailing Address - Fax:
Practice Address - Street 1:40119 STATE HIGHWAY 59
Practice Address - Street 2:
Practice Address - City:BYARS
Practice Address - State:OK
Practice Address - Zip Code:74831-7931
Practice Address - Country:US
Practice Address - Phone:405-361-5055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health