Individual
MS. CAROL THERESE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1908 COOLIDGE AVE, WILLOW GROVE, PA 19090-3017
(215) 657-7668
Mailing address
1908 COOLIDGE AVE, WILLOW GROVE, PA 19090-3017
(215) 657-7668
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
2309
MA
225XG0600X
Gerontology Occupational Therapist
Primary
OC003500L
PA
Other
Enumeration date
04/07/2010
Last updated
04/07/2010
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