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Individual

KYLIE MICHELLE MOAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MASTERS STUDENT

Contact information

Practice address
6448 S WESTERN AVE, OKLAHOMA CITY, OK 73139-1717
(405) 939-5800
Mailing address
3841 NW 24TH ST, OKLAHOMA CITY, OK 73107-1403
(720) 756-5715

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YM0800X
Mental Health Counselor

Other

Enumeration date
11/25/2024
Last updated
11/25/2024
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