Individual
TANISHA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHLEBOTOMY TECH
Contact information
Practice address
2415 MAGNOLIA GARDENS ST # 134B, VACHERIE, LA 70090-5529
(225) 529-4037
Mailing address
14445 RUTHERFORD ST, DETROIT, MI 48227-1872
(225) 529-4037
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
—
—
251E00000X
Home Health Agency
Primary
—
—
374700000X
Technician
—
—
Other
Enumeration date
01/12/2024
Last updated
05/14/2026
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