Individual
EMMALEE GRACE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1965 POLK ST, LARAMIE, WY 82070-6101
(307) 703-0001
Mailing address
1965 POLK ST, LARAMIE, WY 82070-6101
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/21/2017
Last updated
08/21/2017
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