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1396334371
MICHAEL DEWAYNE MOORE
LANCASTER, CA
NPI
1396334371
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-01-13
Last Update Date
2021-01-13
Business Address
MICHAEL DEWAYNE MOORE
44447 10TH ST W
LANCASTER, CA 93534-3324
Phone number: 661-726-2630
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Mailing Address
MICHAEL DEWAYNE MOORE
8508 W AVENUE C
LANCASTER, CA 93536-9415
Phone number: 661-916-0743
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