Candice M. Moore in Jackson - Occupational Therapist
Candice M. Moore - NPI 1174699011
Candice M. Moore is a Occupational Therapist in Jackson, Mississippi. Candice M. Moore practices all healthcare services and medical treatments related to Occupational Therapist. The NPI Number for Candice M. Moore is 1174699011. The last update date is 2007-07-08.
Candice M. Moore's current location address is 4500 Interstate 55 North, Jackson, Mississippi. You can contact this provider via phone number 6013620859 and fax number 6013620870. The mailing address for Candice M. Moore is 4500 Interstate 55 North, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Candice M. Moore |
|---|---|
| Address | 4500 Interstate 55 North, Jackson, Mississippi |
| Phone Number | 6013620859 |
| Fax Number | 6013620870 |
| Sole Proprietor | Y |
| Credentials | OTR L |
NPI Number Detail
| NPI Number | 1174699011 |
|---|---|
| Provider Enumeration Date | 2006-11-24 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4500 Interstate 55 North |
|---|---|
| City | Jackson |
| State | Mississippi (MS) |
| Post Code | 39211 |
| Phone Number | 6013620859 |
| Fax Number | 6013620870 |
Provider's Primary Taxonomy Detail
| Speciality | Occupational Therapist |
|---|---|
| Taxonomy | 225X00000X |
| Licence No | OT1713 |
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Definition: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federat |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5170357 | MS | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Candice M. Moore by the Centers for Medicare & Medicaid Services?
The Candice M. Moore has been assigned the NPI (National Provider Identifier) 1174699011. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Candice M. Moore is physically located?
The Candice M. Moore is situated at the following address: 4500 Interstate 55 North, Jackson, MS 39211.
What is the Candice M. Moore's specialty and taxonomy code?
The Candice M. Moore's specialty is Occupational Therapist, and the corresponding taxonomy code is 225X00000X.
On what date did the Candice M. Moore receive the assignment of its 1174699011 from the Centers for Medicare & Medicaid Services?
The Candice M. Moore was issued its 1174699011 by the Centers for Medicare & Medicaid Services on 2006-11-24.
As of what date were the Candice M. Moore's details last updated?
The information pertaining to the Candice M. Moore, including its address, specialty, and other details, was most recently updated on 2007-07-08.
NPI Number: 1942206313
Address: 1250 N Wenatchee Ave Suite H Pmb 352, Wenatchee, WA