Individual
EMMA LAYNE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10543 S CRATER RD, SOUTH PRINCE GEORGE, VA 23805-7333
(800) 805-6989
Mailing address
1104 CLIFTON DR, COLONIAL HEIGHTS, VA 23834-2202
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
1401216193
VA
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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