Provider Demographics
NPI:1386004026
Name:COX, TAURASA CHANEL (AS)
Entity Type:Individual
Prefix:MS
First Name:TAURASA
Middle Name:CHANEL
Last Name:COX
Suffix:
Gender:F
Credentials:AS
Other - Prefix:MISS
Other - First Name:TAURARSA
Other - Middle Name:CHANEL
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1226 ROYAL DR SW
Mailing Address - Street 2:STE D
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-5925
Mailing Address - Country:US
Mailing Address - Phone:470-377-3977
Mailing Address - Fax:470-443-1736
Practice Address - Street 1:1226 ROYAL DR SW
Practice Address - Street 2:STE D
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-5925
Practice Address - Country:US
Practice Address - Phone:470-377-3977
Practice Address - Fax:470-443-1736
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-23
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management