| NPI | 1063624690 |
|---|---|
| Former Name | DEBRA S MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 59919) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 59919) |
| 101YM0800X Counselor, Mental Health (Licence: TX 59919) | |
| 252Y00000X Early Intervention Provider Agency (Licence: TX 59919) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2024-03-18 |