Samantha Darlene Moore

NPI #1215281407 in Kingston, Oklahoma

Provider Information

NPI Number: 1215281407
Entity Type: Individual
Name: Samantha Darlene Moore
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Nov 9, 2012
Last Updated: Apr 4, 2014

Practice Location

Address: 4334 BACK ST
City: Kingston
State: Oklahoma
ZIP Code: 73439-5350
Phone: (580) 565-0371

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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