Individual
LEANNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 582-2131
Mailing address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 582-2131
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3485
OK
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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