Individual
DOMINIQUE MICHELLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10326 GREENBRIAR PKWY, OKLAHOMA CITY, OK 73159-7643
(405) 881-5057
Mailing address
10112 SPENCER JONES RD, SPENCER, OK 73084-6900
(405) 413-5809
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/22/2017
Last updated
06/22/2017
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