| Doctor Name: | ANN MOORE |
| NPI Number: | 1134398514 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCC, LADAC |
| License Number: | 0089961 |
| Business Practice Address: | 3201 Hwy 314 Sw Los Lunas, NM - 870319764 |
| Business Phone Number: | 5050000000 |
| Business Fax Number: | |
| Mailing Address: | 9 Psalms, LOS LUNAS |
| State: | NM |
| Postal Code: | 870315922 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/29/2008 |
| NPI Last Update Date: | 10/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 0089961 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |