Moore, Jackie Rena

Moore, Jackie Rena is an sole proprietor health care provider with primary practice located at 5721 Oakwood St , Spencer OK 73084-8638. She recently has only one registered license in Behavioral Health & Social Service Providers / Rehabilitation, which is considered as her primary health care specialty. Moore, Jackie Rena can be contacted via phone (405) 413-8416.

Contact Information

Primary practice address
5721 Oakwood St Spencer OK 73084-8638
Phone: (405) 413-8416
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Rehabilitation 103TR0400X

Profile Details

NPI number 1750632782
LBN Legal business name Moore, Jackie Rena
Credentials BHRS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 1st, 2012
Last updated Oct 1st, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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