Individual
HATTIE KELLY-MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
460 MAIN ST, BUFFALO, NY 14202-3203
(716) 855-0163
(716) 855-2023
Mailing address
460 MAIN ST, BUFFALO, NY 14202-3203
(716) 855-0163
(716) 855-2023
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
00359841
NY
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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