MEDICARE: ZENOBIA MOODY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	LPCCANDIDATE13133	OK

General Provider Information

NPI Number	:	1053274019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZENOBIA MOODY

Provider Business Mailing Address
First Line	:	2306 NW 34TH ST
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73505-1936
Country	:	US
Telephone Number	:	801-382-8758
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 NW SHERIDAN RD STE A
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73505-6520
Country	:	US
Telephone Number	:	810-382-8758
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2025
Last Update Date	:	12/06/2025

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Directions to “ ZENOBIA MOODY ” Practice Location

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