| NPI | 1114236619 |
|---|---|
| Other Name | CHARLIE MOORE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2010-09-30 |