Individual
SHELLY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5532 JFK BLVD, NORTH LITTLE ROCK, AR 72116-6708
(501) 588-3211
(501) 353-2599
Mailing address
5532 JFK BLVD, NORTH LITTLE ROCK, AR 72116-6708
(501) 588-3211
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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