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1528666369
CHARLY A MOORE
BURLINGTON, WA
NPI
1528666369
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CO60996036)
Enumeration Date
2020-10-14
Last Update Date
2020-10-14
Business Address
CHARLY A MOORE SUDPT
614 PETERSON RD
BURLINGTON, WA 98233-2606
Phone number: 360-757-0131
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Mailing Address
CHARLY A MOORE SUDPT
1730 LABOUNTY DR # 9-248
FERNDALE, WA 98248-8959
Phone number: 360-510-2996
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