Individual
ANDREA NOELL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11960 WESTLINE INDUSTRIAL DR, SUITE 201, SAINT LOUIS, MO 63146-3209
(314) 819-0480
Mailing address
216 TANNER DR, WENTZVILLE, MO 63385-4635
(636) 373-0118
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2015041600
MO
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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