Organization
MOORE PEDIATRIC THERAPY SERIVCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA C SECURA (CEO)
(910) 673-5437
Entity
Organization
Contact information
Practice address
1163 SEVEN LAKES DR, WEST END, NC 27376
(910) 673-5437
(910) 673-5438
Mailing address
PO BOX 354, WEST END, NC 27376-0354
(910) 673-5437
(910) 673-5438
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
—
—
174400000X
Specialist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7200169
—
NC
Enumeration date
06/13/2008
Last updated
07/10/2023
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