Individual
DENISHA TAHEEMA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4089 PINE GROVE RD, PORT GIBSON, MS 39150-3021
(601) 831-4719
Mailing address
4089 PINE GROVE RD, PORT GIBSON, MS 39150-3021
(601) 831-4719
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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