Provider Demographics
NPI:1861833840
Name:TAYLOR-WOODY, ELZETTA ELIZABETH
Entity Type:Individual
Prefix:
First Name:ELZETTA
Middle Name:ELIZABETH
Last Name:TAYLOR-WOODY
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 1:4501 N CLASSEN BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-4822
Mailing Address - Country:US
Mailing Address - Phone:405-834-6757
Mailing Address - Fax:405-605-2266
Practice Address - Street 1:1330 N CLASSEN BLVD STE G20
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6837
Practice Address - Country:US
Practice Address - Phone:405-605-2292
Practice Address - Fax:405-605-2266
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst