Individual
MARCIA MOODIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13023 218TH ST, LAURELTON, NY 11413-1232
(718) 525-2932
(718) 525-2932
Mailing address
13023 218TH ST, LAURELTON, NY 11413-1232
(718) 525-2932
(718) 525-2932
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
244802-1
NY
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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