| Doctor Name: | KATHLEEN J. WALSH MOORE |
| NPI Number: | 1184853939 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 0710101961 |
| Business Practice Address: | 216 Bush River Drive Farmville, VA - 23901 |
| Business Phone Number: | 4343927049 |
| Business Fax Number: | 4343929221 |
| Mailing Address: | 805 Douglas Church Road, FARMVILLE |
| State: | VA |
| Postal Code: | 23901 |
| Phone Number: | 8042441125 |
| Fax Number: | 4343929221 |
| NPI Enumeration Date: | 07/14/2009 |
| NPI Last Update Date: | 07/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 0710101961 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |