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Individual

MS. DONNA LYNN MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LLBSW

Contact information

Practice address
9409 W PICKWICK CIR, TAYLOR, MI 48180-3860
(313) 854-8013
Mailing address
9409 WEST PICKWICK CICLE, TAYLOR, MI 48180
(313) 854-8013

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802086890
MI

Other

Enumeration date
12/21/2012
Last updated
12/21/2012
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