| NPI | 1295551216 |
|---|---|
| Former Name | KIMBERLY ANN MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 116343) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 101195) |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2026-02-09 |