Individual
LESLIE WISNER MOORER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2075 MAX LUTHER DRIVE, HUNTSVILLE, AL 35810-3859
(256) 852-5600
(256) 852-6722
Mailing address
6608 CHADWELL ROAD, HUNTSVILLE, AL 35802-1810
(256) 797-8301
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2605
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51532739
BLUE CROSS BLUE SHIELD
—
Enumeration date
11/07/2006
Last updated
07/08/2007
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