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General NPI Number Information
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NPI Number | 1033127097
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Entity Type | Individual
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Provider Name | VICKY LYNN MOORE LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 04/11/2008
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Provider Practice Location Address
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Address Line | USA MEDDAC BAVARIA UNIT 26610
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City | APO
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State | BAVARIA
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Zip | 09112
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Country | DE
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Telephone | 09662832100
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Fax |
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Provider Business Mailing Address
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Address Line | BIRNENSTEIG 1
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City | AMBERG
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State | BAVARIA
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Zip | 92224
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Country | DE
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Telephone | 09621320968
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | IL
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