Individual
SUSAN JOSEPHINE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
302 GLENWOOD DR, 201, BLOOMINGDALE, IL 60108-3318
(630) 453-2970
Mailing address
302 GLENWOOD DR, 201, BLOOMINGDALE, IL 60108-3318
(630) 453-2970
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/29/2013
Last updated
05/29/2013
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