Individual
DIANNE MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
412 HIGHWAY 90 STE 11, BAY ST LOUIS, MS 39520-3534
(228) 304-2880
Mailing address
412 HIGHWAY 90 STE 11, BAY ST LOUIS, MS 39520-3534
(228) 304-2880
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1456198
MS
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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