Individual
MS. MARLO MOORE-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
302 ERSKINE AVE, KODIAK, AK 99615-6341
(907) 486-6181
(907) 486-4503
Mailing address
302 ERSKINE AVE, KODIAK, AK 99615-6341
(907) 486-6181
(907) 486-4503
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG6469
—
AK
Enumeration date
06/06/2007
Last updated
07/09/2007
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