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1063902179
LORA SHAE MOULTRIE
DAYTONA BEACH, FL
NPI
1063902179
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: FL SW14467)
Enumeration Date
2018-05-14
Last Update Date
2018-09-18
Business Address
LORA SHAE MOULTRIE LCSW
551 NATIONAL HEALTH CARE DR
DAYTONA BEACH, FL 32114-1495
Phone number: 386-323-7500
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Mailing Address
LORA SHAE MOULTRIE LCSW
471 JEANNETTE DR
ORMOND BEACH, FL 32174-6107
Phone number: 386-254-9997
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