Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 105495 | TX |
NPI | 1225159346 |
---|---|
Provider Name | Ms. Leigh Ann Moore |
First Address | Plano, TX 75025-5420 |
Second Address | Richardson, TX 75082-3565 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |