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1285007757
MICHAEL MOORE
WAUKEGAN, IL
NPI
1285007757
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-11-05
Last Update Date
2015-11-05
Business Address
-- MICHAEL MOORE LPC
1113 GREENWOOD AVE
WAUKEGAN, IL 60085
Phone number: 847-244-4434
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Mailing Address
-- MICHAEL MOORE LPC
4215 HICKORY HILLS DR # P APT 111
WAUKEGAN, IL 60087-5318
Phone number: 630-370-2528
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