Tanisha Penn Moore, LADC

NPI #1295018034 in Sand Springs, Oklahoma

Provider Information

NPI Number: 1295018034
Entity Type: Individual
Name: Tanisha Penn Moore, LADC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: LADC
Enumeration Date: Sep 27, 2011
Last Updated: Aug 15, 2024

Practice Location

Address: 2727 S 137TH WEST AVE
City: Sand Springs
State: Oklahoma
ZIP Code: 74063-5017
Phone: (918) 245-0231

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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