ANTWON DEMETRIUS MOORE
NPI 1417212333
Counselor - Professional in Oklahoma City, OK
Active since July 06, 2012
About Antwon Demetrius Moore NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANTWON DEMETRIUS MOORE (NPI 1417212333) is an individual professional provider in Oklahoma City, Oklahoma, licensed in Oklahoma (J082366771) and active in the NPI registry since July 2012.
NPPES Registry Identity
NPI1417212333
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameANTWON DEMETRIUS MOORE
Location Address500 N MERIDIAN AVEOklahoma City, OK 73107-5700
Mailing Address811 N Oak StPonca City, OK 74601-3216 · (580) 491-0699
Phone(405) 601-1716
Sole ProprietorNo
Enumeration DateJuly 6, 2012
✔ NPI 1417212333 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in OK · J082366771
500 N MERIDIAN AVE, Oklahoma City, OK 73107
Other Names 1
Other Name (5)Antwon Demetrius Burks
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Counselor (Mental Health)
500 N MERIDIAN AVE, #304
OKLAHOMA CITY, OK 73107
OKLAHOMA CITY, OK 73107
Student in an Organized Health Care Education/Training Program
500 N MERIDIAN AVE, 408
OKLAHOMA CITY, OK 73107
OKLAHOMA CITY, OK 73107
Social Worker (Clinical)
500 N MERIDIAN AVE, SUITE 304
OKLAHOMA CITY, OK 73107
OKLAHOMA CITY, OK 73107
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417212333, enumerated as an "individual" on July 06, 2012.
The provider is located at 500 N MERIDIAN AVE OKLAHOMA CITY, OK 73107 and the phone number is (405) 601-1716.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
