NPI | 1700030236 |
---|---|
Former Name | AMY MARIE MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1700181) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH S.0025977) |
101YM0800X Counselor, Mental Health (Licence: OH E.1700181) | |
Enumeration Date | 2008-11-11 |
Last Update Date | 2017-05-09 |