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Individual

CHARLSIE MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1532 CHADWICK WAY, TALLAHASSEE, FL 32312-3774
(850) 895-1611
Mailing address
1532 CHADWICK WAY, TALLAHASSEE, FL 32312-3774

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT17932
FL

Other

Enumeration date
09/04/2018
Last updated
09/04/2018
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