Tanisha Penn Moore, LADC

NPI 1295018034 · on the registry since 2011

Practice

Address: 2727 S 137th West Ave
Sand Springs, OK 74063
Phone: (918) 245-0231
Fax: (918) 241-5031
Organisation at this address: Well Spoken
Tulsa Boys' Home
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 24

Registry record

Primary taxonomy: 101YA0400X
101YA0400X
Licence states on file: OK
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2024-08-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma