Provider Demographics
NPI:1922766773
Name:CLAIR, TAYLOR BREANNE
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:BREANNE
Last Name:CLAIR
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 1:6102 82ND ST STE 10
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-0802
Mailing Address - Country:US
Mailing Address - Phone:806-993-3333
Mailing Address - Fax:
Practice Address - Street 1:6102 82ND ST STE 10
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-0802
Practice Address - Country:US
Practice Address - Phone:806-993-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician