Individual
MRS. BOBBIE JUNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, PSRS, CMD
Contact information
Practice address
608 HWY 271 NORTH, ANTLERS, OK 74523
(580) 298-5062
(580) 298-5072
Mailing address
608 HWY 271 NORTH, ANTLERS, OK 74523
(580) 298-5062
(580) 298-5072
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200111200A
—
OK
Enumeration date
04/12/2007
Last updated
07/02/2010
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