Organization
MOORE AUTISM CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTIN G WARD PH.D. (OWNER/DIRECTOR)
(405) 735-6333
Entity
Organization
Contact information
Practice address
1044 SW 4TH ST, MOORE, OK 73160-2405
(405) 735-6333
Mailing address
1044 SW 4TH ST, MOORE, OK 73160-2405
(405) 735-6333
(405) 735-6629
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1011
OK
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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