Individual provider · Type 1 NPI

Tanisha Penn Moore, LADC

Addiction (Substance Use Disorder) Counselor · Sand Springs, OK

NPI number 1295018034 Active

Practice location

2727 S 137th West Ave
Sand Springs, OK 74063-5017

Call (918) 245-0231 Map

Fax (918) 241-5031

Mailing address

11106 N 133rd East Ave
Owasso, OK 74055-5639

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X917 (OK)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1295018034

Tanisha Penn Moore, LADC's National Provider Identifier is 1295018034, issued on Sep 27, 2011. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Sand Springs, OK. The record was last updated on Aug 15, 2024.