Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225C00000X | Rehabilitation Counselor |
NPI | 1073848693 |
---|---|
Provider Name | Deborah Moos |
First Address | Oklahoma City, OK 73132-4186 |
Second Address | Midwest City, OK 73130-5270 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2009 |
Last Update Date | 28/10/2019 |