Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1356763262 |
---|---|
Provider Name | Eve Moor |
First Address | Lakewood Ranch, FL 34202-1827 |
Second Address | Lakewood Ranch, FL 34202-1827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2014 |
Last Update Date | 11/01/2014 |