Individual
LEAH JO MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
6535 CHESTER AVE, JACKSONVILLE, FL 32217-2247
(904) 731-8230
Mailing address
4450 HUNTINGTON FOREST BLVD, JACKSONVILLE, FL 32257-7597
(904) 625-1951
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
19685
FL
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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