Ebony Dawn Moore | Louisville, KY • PECOS Search

Ebony Dawn Moore

Social Worker

Behavioral Health & Social Service Providers

800 Zorn Ave, Louisville, KY 40206-1433

(502) 287-4000 (502) 749-9785

PECOS Enrollment

Based on the most recent information from CMS, provider Ebony Dawn Moore does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1194735092
Provider Type
Individual
Full Name
Moore, Ebony Dawn
Title
Ms.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
8/9/2006
Last Updated
7/8/2007

Contact Information

Practice Location

800 Zorn Ave, Louisville, KY 40206-1433

Unlisted Fax

Mailing Location

11706 Autumn Forest Ct, Louisville, KY 40229-4600

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 4761 Kentucky