Individual
MALINDA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10668 LYDIA LN, DANVILLE, AR 72833-6890
(479) 567-1090
Mailing address
PO BOX 105, ADONA, AR 72001-0105
(479) 567-1090
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1718
AR
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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