Individual
CHANEL MARIE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19930 JUNIPER AVE, LYNWOOD, IL 60411
(708) 248-4423
Mailing address
19930 JUNIPER AVE, LYNWOOD, IL 60411
(708) 248-4423
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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