Individual
JESSICA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, CM II
Contact information
Practice address
909 ALAMEDA ST, NORMAN, OK 73071-5229
(405) 360-5100
Mailing address
909 ALAMEDA ST, NORMAN, OK 73071-5229
(405) 360-5100
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100734740-F
—
OK
Enumeration date
02/16/2011
Last updated
07/02/2015
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