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NPI Code Detail

MEDICARE: BOBBI MOORE

MEDICARE: BOBBI 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) Counselor161395OH

General Provider Information

NPI Number : 1326550971
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOBBI MOORE
Provider Business Mailing Address
First Line : 213 E CHESTNUT ST
Second Line :
City : MOUNT VERNON
State : OH
Zip : 43050-3404
Country : US
Telephone Number : 740-326-9255
Fax Number :
Provider Business Practice Location Address
First Line : 213 E CHESTNUT ST
Second Line :
City : MOUNT VERNON
State : OH
Zip : 43050-3404
Country : US
Telephone Number : 740-326-9255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2017
Last Update Date : 11/03/2017

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Directions to “ BOBBI MOORE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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