Organization
CHILD AND FAMILY THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LOU ANN MOORE LPC, MED, NCC, NCSC (COUNSELOR)
(405) 202-2583
Entity
Organization
Contact information
Practice address
2500 S BROADWAY, BUILDING 1, SUITE 110, EDMOND, OK 73013-4038
(405) 202-2583
Mailing address
1705 GLACIER LN, EDMOND, OK 73003-4662
(405) 202-2583
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3207
OK
Other
Enumeration date
07/26/2010
Last updated
07/26/2010
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