Individual
CAROLYN NEOMA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
12007 S CEDAR AVE, JENKS, OK 74037-3344
(918) 296-0355
Mailing address
12007 S CEDAR AVE, JENKS, OK 74037-3344
(918) 296-0355
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
07/14/2007
Last updated
07/14/2007
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