Individual
KEYIANA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6131 W LOCUST ST, MILWAUKEE, WI 53210-1465
(414) 502-4623
Mailing address
6131 W LOCUST ST, MILWAUKEE, WI 53210-1465
(414) 502-4623
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
WI
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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