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1801362983
IDA MOORE
EDMOND, OK
NPI
1801362983
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OK 3156)
Enumeration Date
2018-10-16
Last Update Date
2018-10-16
Business Address
IDA MOORE LPC
16224 EVERGLADE LN
EDMOND, OK 73013-1259
Phone number: 405-609-4307
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Mailing Address
IDA MOORE LPC
16224 EVERGLADE LN
EDMOND, OK 73013-1259
Phone number: 405-609-4307
Copy
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