| NPI | 1508258583 |
|---|---|
| Former Name | HEATHER JEAN MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5008781) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024172398) |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2016-09-01 |