Individual
DR. CANDICE A. MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
815 S ASH ST, NEVADA, MO 64772-3222
(417) 667-8352
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
R6883
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200189009
—
MO
Enumeration date
02/22/2006
Last updated
12/18/2013
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