ETHEL FAY MOORE

LANCASTER, CA
NPI1104944792
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
(Licence: CA  na)
Additional Taxonomies225400000X Rehabilitation Practitioner
(Licence: CA  na)
Enumeration Date2007-03-26
Last Update Date2007-07-08
Business Address
-- ETHEL FAY MOORE CPRP
43423 DIVISION ST STE 107
LANCASTER, CA 93535-4640
Phone number: 661-726-2850
Mailing Address
-- ETHEL FAY MOORE CPRP
14575 STONECRESS ST
VICTORVILLE, CA 92394-7021
Phone number: