Individual
AMY KATHERINE MOFFETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
218 FAST ICE DR, MIDLAND, MI 48642-6167
(989) 631-5140
(989) 631-3343
Mailing address
218 FAST ICE DR, MIDLAND, MI 48642-6167
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802089504
MI
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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