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Individual

KRISTAN REA'SHEAL MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3621 N KELLEY AVE, SUITE 100, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
Mailing address
7512 KNIGHT LAKE DR, APT 248, OKLAHOMA CITY, OK 73132-6022
(405) 219-2966

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
G080968864
OK

Other

Enumeration date
04/04/2013
Last updated
04/04/2013
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