Individual
MR. DALE KURT MOORE
Active
Individual
MR. DALE KURT MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
2943
AZ
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
Update your record
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