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Individual

SHENITTA MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1401 RIVER RD, RM 534, GREENWOOD, MS 38930-4030
(662) 455-8165
Mailing address
1401 RIVER RD, RM 534, GREENWOOD, MS 38930-4030

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
24524
MS
2084P0800X
Psychiatry Physician
MD.207220
LA

Other

Enumeration date
03/20/2012
Last updated
04/06/2017
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