Individual
CORRISHA SHANEE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1728 S CARSON AVE, TULSA, OK 74119-4610
(918) 406-3420
Mailing address
8716 E 72ND PL APT 205, TULSA, OK 74133-3181
(918) 262-0278
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/21/2022
Last updated
12/20/2023
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