Taylor Sullivan
Behavior Technician in Edmond, OK. Individual provider (NPI-1).
NPI number1366048639
StatusActive
Last updated in NPPESMay 28, 2021
Details
- NPI
- 1366048639
- Entity type
- Individual (NPI-1)
- Name
- Taylor Sullivan
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 10, 2020
- Certification date
- May 28, 2021
- Last updated
- May 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
2248 Nw 164th StEdmond, OK 73013-8801
Phone 405-605-2663 · Fax 405-562-3753
Mailing address
3517 Nw 164th TerEdmond, OK 73013-9471
Phone 405-605-2663 · Fax 405-562-3753
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