Individual
MS. MARY SARA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCH NP
Contact information
Practice address
126 MISSOURI AVE, MCXP - CCS - CR, FORT LEONARD WOOD, MO 65473-8952
(573) 596-0417
(573) 596-0524
Mailing address
126 MISSOURI AVE, MCXP - CCS - CR, FORT LEONARD WOOD, MO 65473-8952
(573) 596-0417
(573) 596-0524
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
152094
MO
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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