Individual
MARY AQUINAS MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 OAK TER, ARDEN, NC 28704-2917
(818) 664-8566
Mailing address
110 OAK TER, ARDEN, NC 28704-2917
(818) 664-8566
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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