Provider Demographics
NPI:1891436408
Name:MOORE, ALICIA (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12916 GRENADE LN
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22551-8014
Mailing Address - Country:US
Mailing Address - Phone:540-538-8387
Mailing Address - Fax:
Practice Address - Street 1:12916 GRENADE LN
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22551-8014
Practice Address - Country:US
Practice Address - Phone:540-538-8397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA14727374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula