NPI | 1003097999 |
---|---|
Former Name | STACY ERIN MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 14346) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000898) |
Enumeration Date | 2007-11-19 |
Last Update Date | 2023-12-18 |