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Individual
SHAWNA DONISE MOORE
Active
Individual
SHAWNA DONISE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD, LPC, BCBA
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4885
OK
103K00000X
Behavior Analyst
1-15017996
OK
Other
Enumeration date
04/12/2011
Last updated
02/26/2020
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