Individual
JOHNICE AEIDA YVETTE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
226 MCGEE RD, ANDERSON, SC 29625-2104
(864) 260-4168
Mailing address
210 STREAMS WAY, ANDERSON, SC 29625-5148
(919) 475-9375
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11953
SC
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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