Individual
KRISTIAN NICOLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
133 SFC 342, FORREST CITY, AR 72335-7435
(870) 270-9596
Mailing address
133 SFC 342, FORREST CITY, AR 72335-7435
(870) 270-9596
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT2017-008
AR
Other
Enumeration date
05/12/2017
Last updated
05/12/2017
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