Individual
MRS. NATASHA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
153 MAPLE ST, GRETHEL, KY 41631-6321
(606) 497-5507
Mailing address
153 MAPLE ST, GRETHEL, KY 41631-6321
(606) 497-5507
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
201199560
KY
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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