Individual
MICHELE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1201 RURAL AVE, WILLIAMSPORT, PA 17701-1669
(570) 323-4340
Mailing address
120 EDGEWOOD AVE, DUBOISTOWN, PA 17702-6713
(570) 323-5688
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP002617L
PA
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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