Individual
JESSICA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1665 SARATOGA WAY, EDMOND, OK 73003-3552
(405) 880-5120
Mailing address
3018 NW 48TH ST, OKLAHOMA CITY, OK 73112-6030
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
235Z00000X
Speech-Language Pathologist
Primary
CF922
OK
Other
Enumeration date
03/22/2021
Last updated
06/08/2026
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