| NPI | 1134501018 |
|---|---|
| Former Name | AMANDA MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC P009831) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NC C010915) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2021-10-27 |