Individual
RAQUEL VANN-MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1320 NE 1ST PL, PRYOR, OK 74361-4406
(918) 825-5311
Mailing address
14143 E 91ST ST N, OWASSO, OK 74055-2760
(918) 693-1750
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1794
OK
Other
Enumeration date
03/20/2022
Last updated
03/20/2022
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