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NPI Code Detail

MEDICARE: ANGELA MARIA MOORE MA,LSW

MEDICARE: ANGELA MARIA MOORE MA,LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerS00024283OH

General Provider Information

NPI Number : 1306024898
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA MARIA MOORE MA,LSW
Provider Business Mailing Address
First Line : P.O. BOX 29
Second Line :
City : BOWLING GREEN
State : OH
Zip : 43402
Country : US
Telephone Number : 419-352-5387
Fax Number :
Provider Business Practice Location Address
First Line : 1010 N PROSPECT ST
Second Line :
City : BOWLING GREEN
State : OH
Zip : 43402-1335
Country : US
Telephone Number : 419-352-5387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2008
Last Update Date : 02/06/2008

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Directions to “ ANGELA MARIA MOORE MA,LSW” Practice Location

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