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1376140970
KENISHA NICOLE MOORE
FAIRFAX, VA
NPI
1376140970
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: 0)
Enumeration Date
2020-10-06
Last Update Date
2024-01-25
Business Address
KENISHA NICOLE MOORE
8221 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031-4512
Phone number: 703-599-3000
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Mailing Address
KENISHA NICOLE MOORE
5967 PARSONS LN
KING GEORGE, VA 22485-2434
Phone number: 540-413-6247
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