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NPI Code Detail

MEDICARE: CORRINA MOORE

MEDICARE: CORRINA MOORE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor224ZR0403XWV

General Provider Information

NPI Number : 1275122202
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORRINA MOORE
Provider Business Mailing Address
First Line : 184 HOLIDAY HILLS DR
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-8006
Country : US
Telephone Number : 304-424-2400
Fax Number :
Provider Business Practice Location Address
First Line : 184 HOLIDAY HILLS DR
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-8006
Country : US
Telephone Number : 304-420-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2021
Last Update Date : 03/03/2026

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Directions to “ CORRINA MOORE ” Practice Location

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