Individual
DENISE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
554 N LEAVITT RD, AMHERST, OH 44001-1131
(440) 984-3882
Mailing address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5177
(419) 557-5179
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0900829
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104100000X
—
OH
Enumeration date
01/09/2019
Last updated
01/09/2019
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