Individual
ALEXANDRIA LOUISE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
614 S MAIN ST, STILLWATER, OK 74074-4059
(405) 564-3408
Mailing address
423 N E ST, YALE, OK 74085-3539
(918) 960-4492
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-208717
OK
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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