Individual
NINA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3800 SILVER BELL RD, EAGAN, MN 55122-1653
(651) 405-0384
(952) 767-4211
Mailing address
5710 BAKER RD, MINNETONKA, MN 55345-5901
(952) 767-4200
(952) 767-4211
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
104762
MN
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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