Individual
WANACCA EVONY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7147 THOREAU CIR, ATLANTA, GA 30349-7926
(404) 886-5340
Mailing address
7147 THOREAU CIR, ATLANTA, GA 30349-7926
(404) 886-5940
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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