Elizabeth Moore, MOT, OTR/L

Individual provider Active NPI Pediatric Occupational Therapist · Lookout Mountain, TN

NPI 1972293983 · NPPES record last updated May 11, 2023

Key facts

NPI
1972293983
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
License
4761 (TN)
Practice address
210 Franklin Rd
Lookout Mountain, TN 37350-1224
Phone
(423) 635-3035
NPI assigned
May 11, 2023
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4761TNMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 4761 TN Yes

Addresses

Primary practice location

210 Franklin Rd
Lookout Mountain, TN 37350-1224

Mailing address

PO Box 4362
Chattanooga, TN 37405-0362

Other providers in Lookout Mountain, TN

All providers in Lookout Mountain, TN · Pediatric Occupational Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.