Individual
BRENNA E MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
4216 COMMERCIAL LN, DURANT, OK 74701-7785
(580) 924-9441
Mailing address
306 W 3RD, RAVIA, OK 73455
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/03/2010
Last updated
05/03/2010
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