Individual
MARY MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3840 COLONIAL DR, COLUMBUS, IN 47203-2645
(727) 485-3219
Mailing address
21568 E COUNTY ROAD 400 S, WESTPORT, IN 47283-9400
(812) 390-1335
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
CNA0903587
IN
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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