Individual provider · Type 1 NPI

Candice M. Moore, OTR L

Occupational Therapist · Jackson, MS

NPI number 1174699011 Active

Practice location

4500 Interstate 55 North, Suite 291, Highland Village
Jackson, MS 39211

Call (601) 362-0859 Map

Fax (601) 362-0870

Mailing address

766 Clearmont Dr
Pearl, MS 39208-6261

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000XOT1713 (MS)

Occupational Therapist: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork…

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About NPI 1174699011

Candice M. Moore, OTR L's National Provider Identifier is 1174699011, issued on Nov 24, 2006. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in Jackson, MS. The record was last updated on Jul 8, 2007.