Individual
SHAMEKA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
638 S 10TH ST, LAKE WALES, FL 33853-4968
(863) 370-1161
Mailing address
638 S 10TH ST, LAKE WALES, FL 33853-4968
(863) 370-1161
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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