Individual
MS. HALEY COLLEEN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
5108 WINTERBERRY DR, APT C, INDIANAPOLIS, IN 46254-1331
(317) 385-6309
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003008A
IN
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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