Individual
MRS. MADELINE JACKSON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
4810 SETON DR, BALTIMORE, MD 21215-3210
(410) 358-8270
Mailing address
4810 SETON DR, BALTIMORE, MD 21215-3210
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
07531
MD
Other
Enumeration date
11/13/2018
Last updated
01/15/2020
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