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General NPI Number Information
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NPI Number | 1972223089
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Entity Type | Individual
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Provider Name | SHARI LYNN MOORE
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Gender | Female
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 304 S MARKET STREET
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City | DANVILLE
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State | OH
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Zip | 43014
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Country | US
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Telephone | 567-560-3588
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Fax |
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Provider Business Mailing Address
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Address Line | 24802 WEBER RD
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City | HOWARD
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State | OH
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Zip | 43028-9240
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Country | US
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Telephone | 740-975-0457
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.180286
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License Number State | OH
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