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General NPI Number Information
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NPI Number | 1144705344
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Entity Type | Individual
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Provider Name | ROBERT ANTHONY MOORE LPC
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Gender | Male
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 10/03/2018
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Provider Practice Location Address
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Address Line | 520 E LANCASTER AVE
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-2777
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Country | US
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Telephone | 610-873-1005
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Fax | 610-873-3317
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Provider Business Mailing Address
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Address Line | 475 HIBERNIA RD
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City | COATESVILLE
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State | PA
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Zip | 19320-1227
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Country | US
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Telephone | 484-824-1945
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC010746
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License Number State | PA
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