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General NPI Number Information
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NPI Number | 1376264705
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Entity Type | Individual
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Provider Name | AJA MOORE LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/05/2022
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Last Update Date | 09/05/2022
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Provider Practice Location Address
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Address Line | 1735 KELLER SPRINGS RD STE 100
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City | CARROLLTON
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State | TX
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Zip | 75006-2999
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Country | US
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Telephone | 800-993-8244
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Fax |
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Provider Business Mailing Address
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Address Line | 3232 N LOCUST ST APT 1014
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City | DENTON
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State | TX
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Zip | 76207-7494
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 106429
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License Number State | TX
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