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Individual

ROXANN MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/MHS

Contact information

Practice address
1800 S 3RD ST, TERRE HAUTE, IN 47802-1920
(812) 232-4036
(812) 235-0420
Mailing address
3000 S STATE ROAD 135, STE 110, GREENWOOD, IN 46143-9829
(317) 535-4075
(317) 535-4076

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31001814A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000316207
BLUE CROSS BLUE SHIELD
IN
Enumeration date
12/09/2005
Last updated
08/28/2018
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