Individual
ALEXANDRA MARIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2506 N HARRISON ST, SHAWNEE, OK 74804-3131
(405) 214-0300
Mailing address
PO BOX 3675, SHAWNEE, OK 74802-3675
(405) 214-0300
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5373
OK
Other
Enumeration date
09/11/2019
Last updated
11/04/2019
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