Moore, Glenda Marie

Moore, Glenda Marie is an sole proprietor health care provider with primary practice located at 371 Sereno Rd , Corrales NM 87048-8625. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Moore, Glenda Marie can be contacted via phone (505) 352-7391.

Contact Information

Primary practice address
371 Sereno Rd Corrales NM 87048-8625
Phone: (505) 352-7391
Fax: (505) 352-7391
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 1107 New Mexico

Profile Details

NPI number 1801938436
LBN Legal business name Moore, Glenda Marie
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 12th, 2007
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801938436 NPPES
New Mexico MEDICAID A2161
New Mexico MEDICAID Q6968

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