Individual
MRS. KELLI LYN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1032 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-5209
(405) 455-7740
(405) 455-7745
Mailing address
1032 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-5209
(405) 455-7740
(405) 455-7745
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/09/2014
Last updated
05/09/2014
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