Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Taylor Montana Wallace

Individual provider Case Manager/Care Coordinator · NPI 1255165189

Taylor Montana Wallace is a Case Manager/Care Coordinator in Tishomingo, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2024

Practice location Address checks out

602 E 24th St
Tishomingo, OK 73460-3245
Phone: (316) 312-2085
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X (OK)

Record details

NPI number1255165189
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 2, 2024
Last updated in NPPESSeptember 2, 2024
Certification dateAugust 30, 2024

Other providers in Tishomingo