Individual
DANIELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 S 210TH ST, ELKHORN, NE 68022-2166
(308) 520-2907
Mailing address
9205 VALLEY VIEW DR, LA VISTA, NE 68128-3154
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2489
NE
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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