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Individual

MS. ANDREA MOON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
616 MOUNTAIN VALLEY RD, HALLSTEAD, PA 18822-9169
(607) 761-3487
Mailing address
103 JASON ST, AVOCA, PA 18641-1127
(570) 789-1189

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
015762-1
NY
225XP0200X
Pediatric Occupational Therapist
Primary
OC011121
PA

Other

Enumeration date
08/03/2009
Last updated
08/03/2009
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