Individual
GLENDA A MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
529 N GRAND ST, ENID, OK 73701-3216
(580) 234-8880
(580) 234-8891
Mailing address
1419 E PINE AVE, ENID, OK 73701-3531
(580) 234-5738
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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