Individual
RENE' M MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
6211 E SAGUARO VISTA CT, CAVE CREEK, AZ 85331-6431
(602) 725-6648
Mailing address
6211 E SAGUARO VISTA CT, CAVE CREEK, AZ 85331-6431
(602) 725-6648
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
174N00000X
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174N00000X
LACTATION CONSULTANT, NON-RN
AZ
Enumeration date
04/11/2012
Last updated
04/11/2012
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