Individual
DONNA MICHELLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
436 COURT ST STE B, MUSKOGEE, OK 74401-6303
(918) 310-0000
Mailing address
PO BOX 690184, TULSA, OK 74169-0184
(915) 667-4103
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
871844967
—
OK
Enumeration date
02/28/2023
Last updated
02/28/2023
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