Organization
MOORE FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL RIOS LMFT (OWNER)
(405) 659-5858
Entity
Organization
Contact information
Practice address
400 N EASTERN AVE, MOORE, OK 73160-5833
(405) 659-5858
Mailing address
625 VALLEY VIEW RD, NORMAN, OK 73069-9713
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1159
OK
Other
Enumeration date
10/05/2017
Last updated
06/11/2019
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