Provider Demographics
NPI:1619034469
Name:TAYLOR, LEAH SCHUMAN (PHD)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:SCHUMAN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2756 NW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-3234
Mailing Address - Country:US
Mailing Address - Phone:405-948-8522
Mailing Address - Fax:
Practice Address - Street 1:3037 NW 63RD ST
Practice Address - Street 2:SUITE 100W
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3637
Practice Address - Country:US
Practice Address - Phone:405-830-8306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPC #603101YP2500X
OK005106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist