Individual
DIANNE LOUISE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
256 NOKOMIS AVE S STE 2, VENICE, FL 34285-2357
(941) 484-1939
(941) 484-7804
Mailing address
4994 NAUTILUS RD, VENICE, FL 34293-7732
(941) 492-2092
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3289
FL
Other
Enumeration date
12/26/2006
Last updated
09/16/2009
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