Provider Demographics
NPI:1427600048
Name:PROSSER, TAYLOR DAWN (MS)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:DAWN
Last Name:PROSSER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4617 NW LINDY AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-1650
Mailing Address - Country:US
Mailing Address - Phone:580-704-7890
Mailing Address - Fax:
Practice Address - Street 1:1904 NW CACHE RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73507-4539
Practice Address - Country:US
Practice Address - Phone:580-704-7890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-13
Last Update Date:2019-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health