Individual
MS. JILL DIMOND MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, C.C.C.
Contact information
Practice address
4401 S WESTERN AVE, DEPT. 2004215, OKLAHOMA CITY, OK 73109-3413
(405) 636-7131
(405) 644-5476
Mailing address
4401 S WESTERN AVE, DEPT. 2004215, OKLAHOMA CITY, OK 73109-3413
(405) 636-7131
(405) 644-5476
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
239
OK
Other
Enumeration date
04/07/2008
Last updated
04/07/2008
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