Individual
AUSTIN GREGORY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
4913 W RENO AVE, OKLAHOMA CITY, OK 73127-6339
(405) 948-4900
(405) 948-4933
Mailing address
4913 W RENO AVE, OKLAHOMA CITY, OK 73127-6339
(405) 948-4900
(405) 948-4933
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1135
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200456510A
—
OK
Enumeration date
10/03/2012
Last updated
06/15/2021
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