Individual
CAROLINE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2305 WALTON WAY, ROSWELL, GA 30076-3490
(678) 215-1733
Mailing address
2305 WALTON WAY, ROSWELL, GA 30076-3490
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007636
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT007636
OCCUPATIONAL THERAPIST LICENSE
GA
Enumeration date
02/01/2020
Last updated
11/27/2023
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