Individual
MS. MARISSA MICHELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
5060 BRADENTON AVE STE A, DUBLIN, OH 43017-3511
(216) 407-1647
Mailing address
5060 BRADENTON AVE STE A, DUBLIN, OH 43017-3511
(216) 407-1647
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
473399
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0037466
OH
Other
Enumeration date
09/18/2023
Last updated
04/25/2025
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