Individual
MRS. JENNIFER LYNN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4341 BIRCH STREET, SELECTIVE REHAB, NEWPORT BEACH, CA 92660
(949) 475-1002
(949) 475-1003
Mailing address
4341 BIRCH STREET, SELECTIVE REHAB, NEWPORT BEACH, CA 92660
(949) 475-1002
(949) 475-1003
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
864
CA
224Z00000X
Occupational Therapy Assistant
Primary
OTA864
CA
Other
Enumeration date
06/06/2008
Last updated
07/14/2009
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