Mary Jane Moore
Technician, Personal Care Attendant in Wasilla, AK. Individual provider (NPI-1).
NPI number1831761865
StatusActive
Last updated in NPPESJul 9, 2021
Details
- NPI
- 1831761865
- Entity type
- Individual (NPI-1)
- Name
- Mary Jane Moore
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 9, 2021
- Certification date
- Jul 9, 2021
- Last updated
- Jul 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
| 373H00000X | Day Training/Habilitation Specialist | – | – |
Other names
- Mary Jane Combs (Former Name)
Practice location
1401 S Seward Meridian Pkwy # AbcWasilla, AK 99654-8312
Phone 907-631-3520
Mailing address
1401 S Seward Meridian Pkwy # AbcWasilla, AK 99654-8312
Phone 907-631-3520
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All 18 Personal Care Attendant providers in Wasilla · All 3,076 providers in Wasilla
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