Individual
MRS. KELLY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
715 ALMONDWOOD PL, LA VERGNE, TN 37086-3810
(615) 815-7203
Mailing address
PO BOX 65, LA VERGNE, TN 37086-0065
(615) 625-2224
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/03/2021
Last updated
05/03/2021
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