Individual
BRANDI MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
313 S 5TH ST, ODESSA, DE 19730-2078
(302) 376-4128
Mailing address
5424 KILLENS POND RD, FELTON, DE 19943-1902
(302) 284-5810
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
U1-0001998
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U1-0001998
STATE OF DELAWARE
DE
Enumeration date
02/21/2019
Last updated
02/21/2019
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