Individual
ANDREA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 WASHINGTON AVE APT 53, GLEN DALE, WV 26038-1429
(304) 639-7566
Mailing address
610 WASHINGTON AVE APT 53, GLEN DALE, WV 26038-1429
(304) 639-7566
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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