Individual
EVETTE RENEE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1101 LA GRANDE RD, SILVER SPRING, MD 20903-1325
(301) 445-4242
Mailing address
1101 LA GRANDE RD, SILVER SPRING, MD 20903-1325
(301) 445-4242
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT130
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT130
OCCUPATIONAL THERAPY LICENSE NUMBER
DC
Enumeration date
02/18/2015
Last updated
02/18/2015
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