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Individual

JACQUETTA DEAN MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
322 E 23RD ST, BALTIMORE, MD 21218-5811
(410) 499-0938
Mailing address
322 E 23RD ST, BALTIMORE, MD 21218-5811
(410) 499-0938

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Enumeration date
04/17/2007
Last updated
07/08/2007
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