Individual
DENISE MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
501 FAIRMOUNT AVE, STE 302, TOWSON, MD 21286-5457
(410) 927-8768
Mailing address
92 GRAND ST APT 2, HOBOKEN, NJ 07030-2406
(201) 988-4815
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23506
MD
225100000X
Physical Therapist
40QA01124500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23506
LICENSE
MD
01
—
40QA01124500
LICENSE #
NJ
Enumeration date
08/30/2006
Last updated
12/13/2016
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