Tina Marie Moore

NPI #1679173967 in Waterloo, Illinois

Provider Information

NPI Number: 1679173967
Entity Type: Individual
Name: Tina Marie Moore
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Homemaker
Enumeration Date: Oct 27, 2020
Last Updated: Oct 27, 2020

Practice Location

Address: 347 COVINGTON DR STE A
City: Waterloo
State: Illinois
ZIP Code: 62298-3287
Phone: (618) 257-2200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Home Health Aide	374U00000X
Adult Companion	372600000X
Homemaker	376J00000X	Primary

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