Provider Demographics
NPI:1568255537
Name:MOORE, ALLISON RILEY
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:RILEY
Last Name:MOORE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E WITHROW ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-1343
Mailing Address - Country:US
Mailing Address - Phone:419-605-8128
Mailing Address - Fax:419-605-8128
Practice Address - Street 1:225 E WITHROW ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1343
Practice Address - Country:US
Practice Address - Phone:419-605-8128
Practice Address - Fax:419-605-8128
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator