Doctor Name: | DOROTHY MOORE |
NPI Number: | 1184933350 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCDC |
License Number: | 9828 |
Business Practice Address: | 20020 Hwy 35 Alvin, TX - 77511 |
Business Phone Number: | 4097362373 |
Business Fax Number: | |
Mailing Address: | 4352 Emmett F Lowry Expy, TEXAS CITY |
State: | TX |
Postal Code: | 775912628 |
Phone Number: | 4097632373 |
Fax Number: | |
NPI Enumeration Date: | 10/05/2010 |
NPI Last Update Date: | 10/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 9828 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |