Individual
LAURA MOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1630 MERRILL ST, APT 509, SANTA CRUZ, CA 95062-4015
(503) 803-3375
Mailing address
304 N 34TH AVE, YAKIMA, WA 98902-2220
(503) 803-3375
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT60772125
WA
225XP0200X
Pediatric Occupational Therapist
Primary
14669
CA
Other
Enumeration date
09/18/2014
Last updated
05/11/2018
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