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Individual

DELINA L MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1088 WASSERMAN WAY, BATAVIA, OH 45103-1974
(513) 354-5200
Mailing address
1088 WASSERMAN WAY, BATAVIA, OH 45103-1974

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
LCDCIII.161438
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LCDIII.161438
LICENSURE
OH
Enumeration date
10/16/2017
Last updated
10/16/2017
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