Individual
JONI J MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
474367 E 1010 RD, MULDROW, OK 74948-6178
(918) 774-7329
Mailing address
474367 E 1010 RD, MULDROW, OK 74948-6178
(918) 774-7329
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
419
OK
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
09/08/2009
Last updated
05/27/2016
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