Provider Demographics
NPI:1598179806
Name:COX, PRISCILLA TALISHA
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:TALISHA
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 SUMMIT RIDGE DR
Mailing Address - Street 2:APT 202
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-7690
Mailing Address - Country:US
Mailing Address - Phone:773-354-8665
Mailing Address - Fax:
Practice Address - Street 1:2921 NW 156TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-2101
Practice Address - Country:US
Practice Address - Phone:405-513-7794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst