| NPI | 1588020135 |
|---|---|
| Former Name | FONDA MOODY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 172A00000X Driver | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-14 |