Individual
SHANNON ROBERTA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5686 BROADVIEW RD APT 2520, PARMA, OH 44134-1647
(161) 480-6070
Mailing address
5686 BROADVIEW RD APT 2520, PARMA, OH 44134-1647
(161) 480-6070
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
3018684
OH
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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