| Doctor Name: | MS. SHARON VANESSA MOORE |
| NPI Number: | 1023289394 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSHSA |
| License Number: | 178003560 |
| Business Practice Address: | 12517 S Quinn Dr Alsip, IL - 608031098 |
| Business Phone Number: | 7088249812 |
| Business Fax Number: | 6309045274 |
| Mailing Address: | 12517 S Quinn Dr, ALSIP |
| State: | IL |
| Postal Code: | 608031098 |
| Phone Number: | 7088249812 |
| Fax Number: | 6309045274 |
| NPI Enumeration Date: | 03/14/2008 |
| NPI Last Update Date: | 03/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 178003560 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |