Individual
JESSICA NICOLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
500 MARKAVIEW RD NW, HUNTSVILLE, AL 35805-3652
(256) 533-8477
Mailing address
147 HAZEL TRCE, HAZEL GREEN, AL 35750-8887
(256) 665-5619
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3360
AL
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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