Doctor Name: | MRS. BOBBIE JUNE MOORE |
NPI Number: | 1336363100 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BA, PSRS, CMD |
License Number: | |
Business Practice Address: | 608 Hwy 271 North Antlers, OK - 74523 |
Business Phone Number: | 5802985062 |
Business Fax Number: | 5802985072 |
Mailing Address: | 608 Hwy 271 North, ANTLERS |
State: | OK |
Postal Code: | 74523 |
Phone Number: | 5802985062 |
Fax Number: | 5802985072 |
NPI Enumeration Date: | 04/12/2007 |
NPI Last Update Date: | 07/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |