Individual
SHARON MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1400 HIGHLAND RD, SUITE 4, RICHMOND, IN 47374-9239
(765) 939-0820
(765) 939-0920
Mailing address
1400 HIGHLAND RD, SUITE 4, RICHMOND, IN 47374-9239
(765) 939-0820
(765) 939-0920
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31001561A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000220923
ANTHEM
IN
Enumeration date
10/02/2006
Last updated
07/08/2007
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