TANISHA PENN MOORE

SAND SPRINGS, OK
NPI1295018034
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK  917)
Enumeration Date2011-09-27
Last Update Date2024-08-15
Business Address
TANISHA PENN MOORE LADC
2727 S 137TH WEST AVE
SAND SPRINGS, OK 74063-5017
Phone number: 918-245-0231
Mailing Address
TANISHA PENN MOORE LADC
11106 N 133RD EAST AVE
OWASSO, OK 74055-5639
Phone number: 918-527-3014
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