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Individual

MR. RONALD LYNN MOORE SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BEHAVIOR ANALYST

Contact information

Practice address
5720 OAKWOOD ST, SPENCER, OK 73084-8639
(405) 408-9723
Mailing address
5720 OAKWOOD ST, SPENCER, OK 73084-8639
(405) 408-9723

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200025790-B
OK
Enumeration date
06/28/2013
Last updated
06/28/2013
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