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General NPI Number Information
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NPI Number | 1922365352
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Entity Type | Organization
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Legal Business Name | CAROLE MOORE COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 110 UNION BELLE BLVD
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City | SALTILLO
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State | MS
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Zip | 38866-0000
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Country | US
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Telephone | 662-869-3042
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Fax | 662-869-3405
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Provider Business Mailing Address
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Address Line | 110 UNION BELLE BLVD
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City | SALTILLO
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State | MS
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Zip | 38866-0000
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Country | US
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Telephone | 662-869-3042
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Fax | 662-869-3405
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Authorized Official
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Title or Position | OWNER
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Name | CAROLE W MOORE
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Credential | LCSW
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Telephone | 662-790-4600
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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 |
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License Number State |
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