Individual
SHENICKI COLEMAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3540 VALMONT AVE, BEAUMONT, TX 77706-6730
(601) 665-8117
Mailing address
3540 VALMONT AVE, BEAUMONT, TX 77706-6730
(601) 665-8117
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
CO
225XG0600X
Gerontology Occupational Therapist
—
TX
225XG0600X
Gerontology Occupational Therapist
Primary
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
Other
Enumeration date
08/15/2018
Last updated
11/25/2025
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