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NPI Code Detail

MEDICARE: MS. GLORIA ANN MOORE L.M.H.C.

MEDICARE:  MS. GLORIA ANN MOORE  L.M.H.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLH00009503WA

General Provider Information

NPI Number : 1871633065
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GLORIA ANN MOORE L.M.H.C.
Provider Business Mailing Address
First Line : PO BOX 1002
Second Line :
City : LANGLEY
State : WA
Zip : 98260-1002
Country : US
Telephone Number : 360-341-3656
Fax Number :
Provider Business Practice Location Address
First Line : 6442 CENTRAL AVE STE A
Second Line :
City : CLINTON
State : WA
Zip : 98236-9698
Country : US
Telephone Number : 360-341-3656
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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Directions to “ MS. GLORIA ANN MOORE L.M.H.C.” Practice Location

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