Erika Moore

Individual provider Active NPI Case Manager/Care Coordinator · Etna, OH

NPI 1750031340 · NPPES record last updated May 3, 2022

Key facts

NPI
1750031340
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
10485 Tollgate Rd SW
Etna, OH 43062
Phone
(000) 000-0000
NPI assigned
Mar 25, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

10485 Tollgate Rd SW
Etna, OH 43062

Mailing address

445 E Dublin Granville Rd
Worthington, OH 43085-3192
Phone (614) 844-3800

Other identifiers

IdentifierTypeStateIssuer
2615030MedicaidOH

Other providers in Etna, OH

All providers in Etna, OH · Case Manager/Care Coordinator in Ohio

Sources for this page

Verify at the official NPI Registry.