Individual
KIELLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
216 JERRI LN, COLUMBIA, SC 29209-3693
(803) 225-5161
Mailing address
216 JERRI LN, COLUMBIA, SC 29209-3693
(803) 225-5161
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
SC
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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