Individual
DIANA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2521 E 15TH ST, CASPER, WY 82609-4126
(307) 441-0245
Mailing address
2521 E 15TH ST, CASPER, WY 82609-4126
(307) 441-0245
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1295709822
WY
Other
Enumeration date
07/28/2025
Last updated
08/05/2025
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