person
Tanisha Penn Moore, LADC
Addiction (Substance Use Disorder) Counselor in Sand Springs, Oklahoma
NPI 1295018034

Tanisha Penn Moore is an Addiction (Substance Use Disorder) Counselor based in Owasso, OK and is specialized in Addiction (Substance Use Disorder). Tanisha Penn Moore practices in Sand Springs, OK and has the professional credentials of LADC. The NPI Number for Tanisha Penn Moore is 1295018034 and holds a License No. 917 (Oklahoma).

The current practice location address for Tanisha Penn Moore is 2727 S 137Th West Ave, Sand Springs, OK and can be reached out via phone at 918-245-0231 and via fax at 918-241-5031.

Location: 2727 S 137Th West Ave, Sand Springs, OK, 74055-5639
person
Provider Profile Details
NPI Number
1295018034
Provider Name
Tanisha Penn Moore
Credential
LADC
Provider Entity Type
Individual
Gender
Female
Address
2727 S 137Th West Ave, Sand Springs, OK, 74055-5639
Phone Number
918-245-0231
Fax Number
918-241-5031
Provider Enumeration Date
09/27/2011
Last Update Date
09/14/2024
institution
Provider Business Practice Location Address Details
Address
2727 S 137Th West Ave
City
State
Zip
74063-5017
Phone Number
918-245-0231
Fax Number
918-241-5031
person
Provider Business Mailing Address Details
Address
2727 S 137Th West Ave
City
State
Zip
74063-5017
Phone Number
918-245-0231
Fax Number
918-241-5031
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
917 (Oklahoma)
Definition
Definition to come...
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