| NPI | 1811253396 |
|---|---|
| Former Name | DEIDRA NICOLE MOODY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD S04035) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR008906) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2019-11-18 |