| NPI | 1477750206 |
|---|---|
| Former Name | SUSAN T. MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO 989434) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: CO 275685) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2007-07-08 |