Individual
LAURIE JOHNSON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1815 ENCLAVE PKWY, APT. 6307, HOUSTON, TX 77077-3671
(281) 920-0573
Mailing address
1307 TRACEWOOD CV, HOUSTON, TX 77077-1546
(281) 589-0789
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107672
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
993770
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY, INC.
—
Enumeration date
02/22/2011
Last updated
02/22/2011
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