Individual
MRS. HOLLY MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
498 MADISON RD., MOCKSVILLE, NC 28041
(704) 754-2743
Mailing address
498 MADISON RD., MOCKSVILLE, NC 28041
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
7888
NC
Other
Enumeration date
04/02/2019
Last updated
04/02/2019
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