| Doctor Name: | LISA MOORE |
| NPI Number: | 1043465552 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | |
| Business Practice Address: | 1711 Parrish Plaza Dr Owensboro, KY - 423013482 |
| Business Phone Number: | 2706910501 |
| Business Fax Number: | 2706910510 |
| Mailing Address: | 1711 Parrish Plaza Dr, OWENSBORO |
| State: | KY |
| Postal Code: | 423013482 |
| Phone Number: | 2706910501 |
| Fax Number: | 2706910510 |
| NPI Enumeration Date: | 11/25/2008 |
| NPI Last Update Date: | 05/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |