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1710734157
SHANNON DAVID MOORE
FREDERICK, MD
NPI
1710734157
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-05-03
Last Update Date
2024-05-03
Business Address
SHANNON DAVID MOORE
201 BROADWAY ST
FREDERICK, MD 21701-6695
Phone number: 240-801-7799
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Mailing Address
SHANNON DAVID MOORE
16628 SHEA LN
GAITHERSBURG, MD 20877-1232
Phone number:
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