Doctor Name: | MS. TERRY EILEEN MOORE |
NPI Number: | 1841411964 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 3247 |
Business Practice Address: | 910 Pierremont Road Suite 410 Shreveport, LA - 71106 |
Business Phone Number: | 3188658616 |
Business Fax Number: | 3188658617 |
Mailing Address: | 915 Elmwood Street, SHREVEPORT |
State: | LA |
Postal Code: | 71104 |
Phone Number: | 3184535774 |
Fax Number: | 3188658617 |
NPI Enumeration Date: | 05/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3247 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |