Individual
SANJANA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 E COOLEY DR, STE. 101, COLTON, CA 92324-3941
(909) 783-1111
Mailing address
1001 E COOLEY DR, STE. 101, COLTON, CA 92324-3941
(909) 783-1111
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
4267
CA
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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