Individual
SALLY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4131 NW 28TH LN STE 3A, GAINESVILLE, FL 32606-6665
(352) 374-7155
Mailing address
3705 SW 27TH ST APT 827, GAINESVILLE, FL 32608-7021
(352) 246-4716
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
07/06/2012
Last updated
07/06/2012
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