Jackie Rena Moore
Rehabilitation Psychologist
5721 Oakwood St
Spencer
, Oklahoma 73084-8638
Jackie Rena Moore
Rehabilitation Psychologist
5721 Oakwood St
Spencer
, Oklahoma 73084-8638
(405) 413-8416
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About
Features
Specialties
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Jackie Rena Moore
- 5721 Oakwood St
- Spencer, OK
- Zip : 73084-8638
- Phone : (405) 413-8416
Second Address
- Jackie Rena Moore
- 5721 Oakwood St
- Spencer, OK
- Zip : 73084-8638
- Phone : (405) 413-8416
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TR0400X | Rehabilitation Psychologist |
National Provider Identifier
| NPI | 1750632782 |
|---|---|
| Provider Name | Jackie Rena Moore |
| First Address | Spencer, OK 73084-8638 |
| Second Address | Spencer, OK 73084-8638 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/10/2012 |
| Last Update Date | 01/10/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.