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1922369511
OCTAVIA MOORE
LAKE VILLAGE, AR
NPI
1922369511
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2012-05-31
Last Update Date
2012-05-31
Business Address
-- OCTAVIA MOORE
608 S HIGHWAY 65 82 STE B
LAKE VILLAGE, AR 71653-1744
Phone number: 870-265-3711
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Mailing Address
-- OCTAVIA MOORE
602 N WALTON BLVD
BENTONVILLE, AR 72712-4576
Phone number: 479-464-1060
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