Individual
KISHA CHANETTE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
152 QUIET RD, SICKLERVILLE, NJ 08081-5621
(609) 915-6387
Mailing address
152 QUIET RD, SICKLERVILLE, NJ 08081-5621
(609) 915-6387
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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