Doctor Name: | TAMMY LYNN MOORE |
NPI Number: | 1659665750 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW-S |
License Number: | I0700225-S |
Business Practice Address: | 2700 E Main St Suite 102 Bexley, OH - 432092536 |
Business Phone Number: | 6143981180 |
Business Fax Number: | |
Mailing Address: | 1200 W 5th Ave, Suite 102-d COLUMBUS |
State: | OH |
Postal Code: | 432122503 |
Phone Number: | 6143981180 |
Fax Number: | |
NPI Enumeration Date: | 06/06/2011 |
NPI Last Update Date: | 01/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I0700225-S |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |