Individual
BRENDAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
12127 STATE HWY 14 N, CEDAR CREST, NM 87008-9461
(505) 286-3678
Mailing address
316 WELLESLEY DR SE, ALBUQUERQUE, NM 87106-1422
(808) 365-3931
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
—
—
225X00000X
Occupational Therapist
Primary
2106
NM
Other
Enumeration date
12/18/2015
Last updated
03/08/2021
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