Individual
KHADIJAH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 GALENA CT, ERIAL, NJ 08081-4320
(973) 698-6470
Mailing address
1 GALENA CT, ERIAL, NJ 08081-4320
(973) 698-6470
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06166800
NJ
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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