| NPI | 1275089120 |
|---|---|
| Former Name | MICHELLE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC16286) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME 16286) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2019-10-14 |